{
  "abstract": "Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive neurological disorder, with an estimated incidence of 1 in 125 million. The condition is characterized by a clinical feature of unexplained pyrexia, global insensitivity to pain, anhidrosis, intellectual disability, and self-mutilating behavior. While musculoskeletal complications, such as fractures and joint dislocations are common, severe neuropathic arthropathy represents one of the most debilitating skeletal manifestations; however, its specific incidence remains unrecorded in present medical literature. Due to progressive joint destruction and gross instability, limb salvage and functional restoration remain a significant surgical challenge. A tertiary care orthopedic center reported the case of a 24-year-old female, who was wheelchair-bound for 7 years and presented with a painless, severely deformed, and unstable ankle complicated by a history of recurrent infections. A diagnosis of a flail neuropathic ankle secondary to CIPA was established. To achieve limb salvage, the patient underwent hindfoot arthrodesis utilizing the \"superconstruct\" principle. This approach aimed to provide a stable, plantigrade foot through rigid internal fixation and intensive post-operative rehabilitation. Clinical and radiological union was well-established by 10 weeks, at which point assisted mobilization was achieved. At the 1-year follow-up, radiological assessment confirmed solid bony fusion, and the patient was successfully ambulating without assistance. Managing a neuropathic flail ankle in the context of CIPA requires meticulous pre-operative planning, a detailed diagnostic workup, and aggressive post-operative management with respect to wound care and rehabilitation. This case demonstrates that hindfoot arthrodesis utilizing a plate-and-screw superconstruct provides the mechanical stability necessary to overcome the biomechanical challenges of CIPA, proving that limb salvage and functional restoration are achievable goals.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedic Surgery, Institute of Orthopaedics and Traumatology, Madras Medical College, Chennai, Tamil Nadu, India."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "T Tholgapiyan",
      "orcid": "0009-0001-4190-0473"
    },
    {
      "affs": [
        0
      ],
      "name": "Senthilkumar Sivakumar",
      "orcid": "0009-0005-2347-0499"
    },
    {
      "affs": [
        0
      ],
      "name": "Madhan Athmanathan",
      "orcid": "0009-0009-9173-1960"
    },
    {
      "affs": [
        0
      ],
      "name": "T Dilip Kumar",
      "orcid": "0009-0008-0518-4845"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1mjmq53ekn5m1.bib",
  "cited_by": 0,
  "doi": "10.13107/jocr.2026.v16.i11.8380",
  "fulltext_url": "https://europepmc.org/articles/PMC13740952",
  "id": "1mjmq53ekn5m1",
  "issns": [
    "2250-0685",
    "2321-3817"
  ],
  "landing_url": "https://europepmc.org/article/MED/42997090",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2732|Foot and Ankle Surgery"
    ]
  ],
  "openalex": "W7225592291",
  "pdf_url": "https://europepmc.org/articles/PMC13740952?pdf=render",
  "pmcid": "PMC13740952",
  "pmid": "42997090",
  "published": "2026-11-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1mjmq53ekn5m1.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:34Z",
      "native_id": "MED:42997090",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42997090"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Foot and Ankle Surgery",
      "subfield": "surgery"
    }
  ],
  "title": "Limb Salvage of a Flail Neuropathic Ankle in Congenital Insensitivity to Pain with Anhidrosis Using a Hindfoot Superconstruct.",
  "title_text": "Limb Salvage of a Flail Neuropathic Ankle in Congenital Insensitivity to Pain with Anhidrosis Using a Hindfoot Superconstruct.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:34Z",
  "url": "https://research.draconitic.com/paper/1mjmq53ekn5m1",
  "venue": "Journal of orthopaedic case reports",
  "versions": []
}