Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CLUBFOOT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMedDate not supplied

Variation in CASP10 gene is associated with idiopathic talipes equinovarus.

Idiopathic talipes equinovarus (ITEV), more commonly known as clubfoot, is a developmental deformity characterized by rigid ankle equinus, hindfoot varus, and forefoot adduction. This common birth defect is treatable, but the etiology of ITEV is largely unknown. Recently, a deletion in the chromosomal region 2q31-33 was found to be associated with clubfoot. Microsatellite markers spanning the region were genotyped in 57 multiplex ITEV families and 83 simplex trios. Family-based analysis revealed that two microsatellite markers, GATA149B10 and D2S1371, were associated with ITEV in the simplex trios. The 6cM region between the two markers contained the candidate genes CASP8, CASP10, and CFLAR. These genes encode proteins that are regulators of apoptosis, which is important during growth and development. Genotyping of SNPs throughout the genes in this sample of ITEV families has revealed positive linkage with association to the major allele of a variant in CASP10 in simplex ITEV white and Hispanic trios. This study is the first to find evidence for a candidate gene for ITEV and provides a scientific foundation to further explore the contributions of other apoptotic genes in the etiology of clubfoot.

CASP8 and FADD-Like Apoptosis Regulating Protein↗
PubMed2004

Possible association between different congenital abnormalities and use of different sulfonamides during pregnancy.

The objective of the study presented here was to check the debated human teratogenic potential of sulfonamide drugs. Five different sulfonamides such as sulfamethazine, sulfathiourea, sulfamethoxypyridazine, sulfamethoxydiazine and the combination of sulfamethazine-sulfathiourea-sulfamethoxypyridazine were differentiated. Cases with congenital abnormalities were compared with their matched controls without congenital abnormalities in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. Of 38,151 newborn infants without any congenital abnormalities (control group), 163 (0.4%) had mothers who were treated with the sulfonamides studied during pregnancy, while of 22,843 cases with congenital abnormalities, 140 (0.6%) had mothers who were treated with the sulfonamides studied during pregnancy. The analysis of cases and matched controls indicated a higher rate of cardiovascular malformation (adjusted prevalence odds ratios [POR] with 95% CI: 3.5, 1.9-6.4) and clubfoot (adjusted POR with 95% CI: 2.6, 1.1-6.2) in infants born to mothers with sulfonamide treatment in the second and third months of pregnancy. The detailed analysis of different sulfonamides showed a possible association between cardiovascular malformations (adjusted POR with 95%; CI: 6.5, 2.6-15.9), particularly ventricular septal defect (17.1, 1.3-141.1) and sulfamethoxydiazine during the second and third months of pregnancy. In addition, a possible association was found between clubfoot and sulfathiourea, both during the entire pregnancy (adjusted POR with 95% CI: 2.3, 1.2-4.3) and in the second and third months of gestation (3.9, 1.1-13.8). Thus, maternal treatment of sulfamethoxydiazine may cause ventricular septal defect, while sulfathiourea may induce clubfoot; however, further studies are needed to verify or reject these associations.

Abnormalities, Drug-Induced↗
PubMed1980

Talo-calcaneal osteotomy and soft tissue procedures in the treatment of clubfeet. I. Indications, principles and technique.

By simultaneous arthrography of the talocrural and talonavicular joints it is possible to demonstrate and measure the most important skeletal deformities in clubfoot. In this way it has been possible to establish the indications for alternative forms of treatment with a greater degree of precision. Most of our refractory or recurrent clubfeet have been treated successfully by various soft tissue procedures. In cases with severe talar deformity, however, these procedures have been complemented by correction osteotomy through the talar neck and calcaneus. The aim is to create muscle balance by soft tissue procedures and to correct pronounced skeletal deformities by osteotomy. This treatment plan has been used in about 50 of our clubfoot cases. The principles, objectives and indications of the surgical therapy are discussed in this article. The operative technique, as it has been developed with increasing experience, is described, and if careful attention is paid to all details the risk of complications is small and the correction is generally satisfactory. It must be emphasized that correction osteotomy is only a part of an overall treatment plan and that this operation is only indicated in a minority of clubfoot cases.

Achilles Tendon↗
PubMed1999

The role of bilateral talectomy in the management of bilateral rigid clubfeet.

Severe clubfoot is a common sequela of arthrogryposis multiplex congenita and myelomeningocele. Talectomy is a practical surgical procedure to assist in the correction of severe, rigid equinovarus foot deformity. However, the results of talectomy may be less predictable in rigid bilateral equinovarus foot deformity than in the treatment of unilateral clubfoot. To determine the outcome of talectomy in the treatment of bilateral rigid clubfoot, we reviewed the cases of all patients at our center who underwent bilateral talectomy. Seven children were treated for bilateral talipes equinovarus with talectomy. The patient group consisted of 3 children with arthrogryposis, 3 with myelomeningocele, and 1 with Duchenne muscular dystrophy. The age at surgery averaged 6 years and ranged from 1 year and 10 months to 15 years and 7 months. The length of follow-up averaged 5 years and 6 months and ranged from 3 years to 12 years and 6 months. Three feet had a good and 7 feet a satisfactory correction of the deformity. Four feet had poor results. Bilateral talectomy was found overall to be a successful and predictable procedure, with low morbidity for the attainment of functional feet.

Adolescent↗
PubMed1982

Congenital postural deformity association.

The so-called congenital postural deformities were evaluated in the material of the Hungarian Congenital Malformation Registry, 1970-1976. Seven categories of postural deformities: dislocation of the hip, clubfoot, torticollis, musculoskeletal, other limb, face-nose and auricular were separated. The occurrence of the combination of dislocation of the hip, clubfoot and torticollis is manifold of random combination. These three postural deformities, however, are not associated more often with other nonpostural type abnormalities. Thus the congenital postural deformity association composed of two or more combinations of dislocation of the hip, clubfoot and torticollis without other major congenital abnormalities is treated as a provisional entity. Its birth prevalence is 0.4 per 1000 total births thus after Down syndrome it is the second common type of multiple congenital abnormalities. The aetiology and its higher sib-occurrence are explained by intrauterine maternal moulding factors.

Abnormalities, Multiple↗
PubMed1987

Soft tissue anomalies in a patient with congenital tibial aplasia and talo-calcaneal synchrondrosis.

We have carried out the third in a series of anatomical dissections of amputated congenitally deformed human limbs in an attempt to determine the etiological relationship between the bony and soft tissue anomalies. This specimen consisted of a limb with congenital tibial aplasia and an adducted foot with five toes. The arterial and nerve patterns were reminiscent of those seen previously by us. The arteries were characterized by absence of the anterior tibial artery and an incomplete plantar arch. The superficial peroneal nerve terminated at the ankle. Extra branches from the sural, deep peroneal, and medial plantar nerves supplied branches to the dorsum of the foot. There were two extra muscles in the leg. The remaining muscles were normal, with the exception that most muscles normally inserting on the plantar surface of the foot inserted instead into a common tendon sheet. The tibia was replaced by a tendinous band, and the talus and calcaneus were united by a complete synchondrosis. The contralateral limb clinically appeared to have a clubfoot. The combination of an absent anterior tibial artery and an incomplete plantar arch is consistent with our theory that a reduced number of vessels puts the embryonic limb at increased risk of congenital defects due to the reduction in the number of collateral blood routes. Some event, such as extravasation of blood or embolization, may concurrently or subsequently compromise blood flow in the remaining vessels. We have previously observed abnormal arterial patterns similar to that described above in limbs having absence of the tibia and in other patients having clubfeet. The presence of abnormal arterial patterns in a limb with absence of the tibia and a contralateral limb with clubfoot suggests that absent tibia and clubfoot may be etiologically related.

Amputation, Surgical↗
PubMed1999

The Richieri-Costa and Pereira form of acrofacial dysostosis: first case in a non-Brazilian infant.

We report on a French boy with cleft mandible, pre/postaxial hand anomalies, and clubfoot born to consanguineous parents. These findings are comparable to those of previous cases of the autosomal recessive Richieri-Costa and Pereira syndrome of short stature, Robin sequence, cleft mandible, pre/postaxial hand anomalies, and clubfoot. This is the first case in a non-Brazilian infant.

Clubfoot↗
PubMed2005

Cartilage anlagen adapt in response to static deformation.

Connective tissue adaptation, including the development of cartilaginous anlagen into bones, is widely believed to be related to dynamic, intermittent load and stress histories. Static stresses, on the other hand, are generally believed deleterious in tissue adaptation. Using serial MRI in a natural human experiment (manipulation and corrective casting of infant clubfoot), we have observed casting produces two effects: (1) the well recognized change in relative positions of the hindfoot anlagen; (2) a newly recognized immediate shape change in the anlagen. These changes seemingly enhance the rate of growth of the anlagen and of the ossific nucleus. The shape change or deformation in the anlagen would occur as a result of alterations in the magnitudes and directions of loading from soft tissue attachments and muscle activity and would necessarily be associated with changes in the stress states within the anlagen and, when present, the ossific nuclei. Given the known role of load and stress history in tissue adaptation, we presume the reduced stress histories influence the enhanced growth rates. These observations contradict some current theories of tissue adaptation since static, rather than dynamic stresses play a crucial role in accelerating the growth and development of anlagen in the infant clubfoot.

Biomechanical Phenomena↗
PubMed1986

Foot deformities in infants and children.

Foot deformities may reflect a generalized disorder, especially a neurologic problem; thus, the child should have a brief general examination. Many infantile foot deformities, such as calcaneovalgus, are postural and self-correcting. Metatarsus varus is not referred for treatment until age 2 months and then only if the deformity is moderate or severe. Fixed forefoot equinus and heel varus characterize a clubfoot, which requires immediate treatment. Corrective shoes are not advised as the primary treatment for metatarsus varus or clubfoot but often are prescribed to maintain the corrected position after serial casts. Flexible flatfoot is a manifestation of a constitutional laxity affecting all ligaments and joints. The feet appear abnormal because of weight-bearing stresses. Most children with flatfoot achieve a partial correction spontaneously. Current research does not document that treatment with corrective shoes or inserts produces a result better than the partial correction that occurs naturally.

Clubfoot↗
PubMedDate not supplied

Amniotic band syndrome.

Amniotic band syndrome is an uncommon, congenital fetal abnormality with multiple disfiguring and disabling manifestations. A wide spectrum of clinical deformities are encountered and range from simple ring constrictions to major craniofacial and visceral defects. Lower extremity limb malformations are extremely common and consist of asymmetric digital ring constrictions, distal atrophy, congenital intrauterine amputations, acrosyndactyly, lymphedema and clubfoot. Although debated, early amnion rupture with subsequent entanglement of fetal parts (mostly limbs and appendages) by amniotic strands is the primary theory of pathogenesis. The sporadic nature of this congenital anomaly is discussed, as well as a case study involving the surgical correction of an associated rigid clubfoot deformity.

Adult↗
PubMed2003

Attention deficit hyperactivity disorder and neurocognitive correlates after childhood stroke.

We investigated the frequency and neurocognitive correlates of attention deficit hyperactivity disorder and traits of this disorder (ADHD/Traits) after childhood stroke and orthopedic diagnosis in medical controls. Twenty-nine children with focal stroke lesions and individually matched children with clubfoot or scoliosis were studied with standardized psychiatric, intellectual, academic, adaptive, executive, and motivation function assessments. Lifetime ADHD/Traits were significantly more common in stroke participants with no prestroke ADHD than in orthopedic controls (16/28 vs. 7/29; Fisher's Exact p < .02). Lifetime ADHD/Traits in the orthopedic controls occurred exclusively in males with clubfoot (7/13; 54%). Participants with current ADHD/Traits functioned significantly worse (p < .005) than participants without current ADHD/Traits on all outcome measures. Within the stroke group, current ADHD/Traits was associated with significantly lower verbal IQ and arithmetic achievement (p < .04), more nonperseverative errors (p < .005), and lower motivation (p < .004). A principal components analysis of selected outcome variables significantly associated with current ADHD/Traits revealed "impaired neurocognition" and "inattention-apathy" factors. The latter factor was a more consistent predictor of current ADHD/Traits in regression analyses. These findings suggest that inattention and apathy are core features of ADHD/Traits after childhood stroke. This association may provide clues towards the understanding of mechanisms underlying the syndrome.

Adaptation, Psychological↗
PubMedDate not supplied

[Treatment results of Imhäuser's method of treating neonatal clubfeet].

The results of treatment of newborn clubfoot are reported 6 years and 3 months after operation. 88 children with 123 clubfeet were treated beginning at the neonatal period with redressment and casting followed by achillotenotomy and dorsomedial and dorsolateral capsulolysis of the talocrural and talocalcaneal joints at 4 to 7 months of age. After that a strict protocol of physiotherapy, orthetics and controlling was used. For clinical and radiological assessment the criteriasof Magone (40) and Simons (51, 52) were used. The significance of parental cooperation was analysed. At follow-up the result was good or acceptable in 83.7% according to clinical findings and 43.6% according radiology respectively. There was obviously no correlation of clinical and radiological findings. The mobility of the ankle joint proved to be important regarding the functional result, especially in cases with flat-top-talus it has been limited. Parenteral cooperation is of special importance for good results in clubfoot-therapy.

Achilles Tendon↗
PubMed1996

Clubfeet in congenital annular constricting bands.

Thirty-five children who had congenital annular constricting bands (Streeter's dysplasia) with associated clubfeet seen by the author from September 1989 to March 1992 were reviewed with respect to quality of the clubfeet,the relationship of the bands with the clubfeet, possible prenatal factors, and treatment results. It was noted that all the clubfeet were rigid even if there were no constricting bands in the leg with the clubfoot. The clubfeet responded poorly to casting (6% success) and 77% required surgical correction. Z-plasties of deep bands were done before clubfoot correction. There was a high incidence of abnormal pregnancies with attempts at abortion in 66% of the cases, suggesting intrauterine insult early in the pregnancy as a factor causing both the clubfeet and the Streeter's dysplasia.

Adult↗
PubMed1984

Contributory etiologic factor for talipes equinovarus in congenital myotonic dystrophy: comparative biopsy study of intrinsic foot musculature and vastus lateralis in two cases.

Biopsy specimens from the feet and proximal thigh musculature of two patients with congenital myotonic dystrophy with talipes equinovarus were compared. The findings were also compared with those reported in muscle biopsy of idiopathic clubfoot. It was concluded that structural change in intrinsic foot muscle can contribute to the force imbalance that produces clubfoot in this disease.

Biopsy↗
PubMed1984

Congenital constriction band syndrome.

Eighty-three patients with congenital constriction band syndrome were reviewed. Clinical manifestations and associated anomalies were analyzed with attention directed to distribution of the involvement. Constriction bands, amputation, and acrosyndactyly were the main clinical manifestations of this syndrome. Involvement of the distal portions of the extremity was most common. In the hand, the central digits were involved most frequently, and the thumb was only minimally affected in most cases. Of the 19 cases with an associated clubfoot deformity, 10 were proven to be a paralytic clubfoot due to compression neuropathy of the peroneal nerve caused by a deep constriction band below the knee, whereas 9 had a normal peripheral nerve.

Amniotic Band Syndrome↗
PubMed2003

Embryonic blastemic changes in retinoic acid-induced hindlimb deformity.

In this study we analyzed, on an experimental model, blastemic changes occurring during the embryonic period that may later cause fetal hindlimb deformity. Experimental induction of clubfoot-like deformity in rat fetuses was performed by maternal administration of retinoic acid (RA) (120 mg/kg body weight) as a single intragastric dose on day 10 of pregnancy (previous phase of this assay). The caudal and hindlimb blastemic changes were studied by mitosis count and stereological, immunohistochemistry and AgNOR techniques in the hindlimbs of 15-day embryos and in the caudal somites of 11-day embryos. In 15-day embryos from the assay group, hypoplasia and misorientation of hindlimbs were present in 90% of the cases. The histological study showed a blastemal defect as follows: (a) reduction in mesenchymal cell activity (mitotic and AgNOR activities); (b) increase of volume of vascular lumen; (c) reduction in volume of nerve structures, and (d) reduction in the percentage of pre-rhabdomyoblastic cells. In 11-day embryos from the assay group, caudal somites showed disruption, including loss of usual morphology. Moreover, somitic AgNOR activity decreased compared to the control group. The greatest reduction in the number of black-dots per cell was in the myotome. These findings suggest that a certain pathology of the somites, very little studied to date, might be involved in clubfoot pathogenesis.

Abnormalities, Drug-Induced↗
PubMed2000

Accessory soleus muscle as a cause of resistance to correction in congenital club foot: a case report.

A 14-month-old female with bilateral clubfeet was initially treated by serial casting and percutaneous tenotomy of the Achilles tendon, bilaterally. Both clubfeet subsequently underwent surgical treatment with a posteromedial release through a Cincinnati incision. At surgery on one clubfoot, an accessory Soleus muscle was found anterior to the Achilles tendon with a distinct insertion on the upper surface of calcaneus, anterior and medial to the insertion of Achilles tendon. This accessory Soleus muscle may have been the cause of resistance to correction in this congenital clubfoot.

Abnormalities, Multiple↗
PubMed1981

Surgical correction of resistant talipes equinovarus: observations and analysis - preliminary report.

The preliminary results of a comprehensive talipes equinovarus release on 16 patients with 20 idiopathic clubfoot deformities were analyzed with an 18-month follow-up. Our conclusions were that each component of the clubfoot can be managed in a single stage operative procedure without any significant risk to the patient; bilateral surgery could be done at the same sitting; and dorsiflexion was difficult to achieve because of the anatomical deformity of the talus and resistant anterior capsule. Fixation after comprehensive release with Kirschner wires is important in maintaining the reduction, and no patient had a return of the deformity after satisfactory correction at the time of surgery. The complications were excessive hindfoot valgus, loss of the longitudinal arch by excessive midfoot release and casts, and forefoot valgus from complete transfer of the anterior tibial.

Child, Preschool↗