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Janatová K, Nováková T, Lopot F. The Incidence of Clubfoot in the Czech Republic: A Nationwide Epidemiological Study from 2000 to 2014. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040714. [PMID: 37189962 DOI: 10.3390/children10040714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/05/2023] [Accepted: 04/09/2023] [Indexed: 05/17/2023]
Abstract
Clubfoot is one of the most common musculoskeletal birth deformities worldwide. The prevalence varies among individual countries and populations. There is a lack of nationwide incidence studies in Central Europe. We analyzed the incidence of clubfoot in the Czech Republic over 14 years. Patients born with clubfoot in the Czech Republic were identified using The National Registry of Congenital Anomalies. Demographic data were included. Data from 2000 to 2014 were collected and analyzed regarding gender and regional distribution. The study's chosen time frame was grounded on the condition of the Czech industry. Following extensive transformations in 1989, the industry eliminated highly non-ecological operations with significant environmental impact and related health risks. The incidence of clubfoot during the study period was 1.9 (95% CI 1.8-2.0) per 1000 births; males comprised the majority (59%). The incidence significantly differed among individual regions of the Czech Republic (p < 0.001). The incidence in the Czech Republic was higher than in previous European studies. We found significant regional differences in incidence, which could indicate that there may be exogenous pathogenic factors. For this reason, we plan to follow up our work with an up-to-date study.
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Affiliation(s)
- Klára Janatová
- Sport Sciences-Biomedical Department, Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 16200 Prague, Czech Republic
| | - Tereza Nováková
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 16200 Prague, Czech Republic
| | - František Lopot
- Sport Sciences-Biomedical Department, Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 16200 Prague, Czech Republic
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Tieleman AA, Damen MJ, Verrips A, Roelofs M, Kamsteeg EJ, Voermans NC. Child Neurology: Maternal Transmission of Congenital Myotonic Dystrophy Type 2: Case Report. Neurology 2022; 99:1112-1114. [PMID: 36180234 DOI: 10.1212/wnl.0000000000201427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022] Open
Abstract
Congenital manifestations in Myotonic Dystrophy type 2 (DM2) point to anticipation and have only rarely been described. We report a three-generation family with genetically confirmed DM2. The youngest family member presented with unilateral congenital pes planovalgus and equinus. Genetic analysis in four family members showed a CCTG repeat expansion in the CNBP gene. We highlight the association between foot deformities and congenital DM2. Remarkably, the transmission to the congenital form of DM2 has been exclusively maternal so far. If this association is confirmed in other families, clinical practice and genetic counseling in DM2 families need to be adapted.
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Affiliation(s)
- Alide A Tieleman
- From the Department of Neurology (A.A.T., M.J.D., N.C.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (A.V.), Canisius Wilhelmina Hospital, Nijmegen; Basalt Medical Rehabilitation Center (M.R.), the Hague; and Department of Genetics (E.-J.K.), Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Manon J Damen
- From the Department of Neurology (A.A.T., M.J.D., N.C.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (A.V.), Canisius Wilhelmina Hospital, Nijmegen; Basalt Medical Rehabilitation Center (M.R.), the Hague; and Department of Genetics (E.-J.K.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Aad Verrips
- From the Department of Neurology (A.A.T., M.J.D., N.C.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (A.V.), Canisius Wilhelmina Hospital, Nijmegen; Basalt Medical Rehabilitation Center (M.R.), the Hague; and Department of Genetics (E.-J.K.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Monique Roelofs
- From the Department of Neurology (A.A.T., M.J.D., N.C.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (A.V.), Canisius Wilhelmina Hospital, Nijmegen; Basalt Medical Rehabilitation Center (M.R.), the Hague; and Department of Genetics (E.-J.K.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Erik-Jan Kamsteeg
- From the Department of Neurology (A.A.T., M.J.D., N.C.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (A.V.), Canisius Wilhelmina Hospital, Nijmegen; Basalt Medical Rehabilitation Center (M.R.), the Hague; and Department of Genetics (E.-J.K.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nicol C Voermans
- From the Department of Neurology (A.A.T., M.J.D., N.C.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (A.V.), Canisius Wilhelmina Hospital, Nijmegen; Basalt Medical Rehabilitation Center (M.R.), the Hague; and Department of Genetics (E.-J.K.), Radboud University Medical Center, Nijmegen, the Netherlands
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Mustari MN, Faruk M, Bausat A, Fikry A. Congenital talipes equinovarus: A literature review. Ann Med Surg (Lond) 2022; 81:104394. [PMID: 36147065 PMCID: PMC9486628 DOI: 10.1016/j.amsu.2022.104394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/05/2022] Open
Abstract
Congenital talipes equinovarus (CTEV) is a congenital disability characterized by leg deformities in the cavus, adducts, varus, and equinus. The etiology of CTEV is poorly understood, despite its incidence ranging from 0.76 to 3.49 cases per 1000 live births in Indonesia. CTEV involves the fixation of the foot in the adducts, varus, and equinus with concurrent soft tissue anomalies. Despite advances in treatment, disability often persists. Theoretical models have been proposed for neurological, vascular, connective tissue, bone, and muscular causes; however, the currently available data suggests that mild cases are associated with intrauterine position. CTEV's etiology appears to involve a hereditary component, as its prevalence varies by ethnic group. Genetic factors have been identified in 24–50% of cases, depending on the community studied. Based on a complex segregation analysis, the most plausible inheritance pattern is a single large-effect gene interacting with a polygenic background. CTEV is a congenital disability characterized by leg deformities in the cavus, adducts, varus, and equinus. In Indonesia, its incidence ranges from 0.76 to 3.49 cases per 1000 live births. Genetic factors have been identified in 24–50% of cases, depending on the community studied.
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Birrer E, Morovic M, Fernández P. PIE BOT: CONCEPTOS ACTUALES. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Zargarbashi R, Abdi R, Bozorgmanesh M, Panjavi B. Anterior Distal Hemiepiphysiodesis of Tibia for Treatment of Recurrent Equinus Deformity Due to Flat-Top Talus in Surgically Treated Clubfoot. J Foot Ankle Surg 2021; 59:418-422. [PMID: 32131014 DOI: 10.1053/j.jfas.2019.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 05/25/2019] [Accepted: 08/18/2019] [Indexed: 02/03/2023]
Abstract
Treatment of persistent or recurrent equinus after repeated surgical releases can be challenging in patients with clubfoot. Anterior distal tibial epiphysiodesis has recently been used in patients with recurrent progressive equinus deformity, with inconsistent outcomes. Herein, we used this technique in a carefully selected subgroup (8 children, 9 feet) of patients with a severe equinus deformity and a flat-top talus. The patients were followed up with radiological and clinical measures for 12 to 18 months. The mean angle of the ankle improved significantly (25.5°, p < .0001). The mean anterior distal tibial angle decreased from 86.3° to 69° (p < .0001). Plantigrade foot was obtained in all patients, except 1 with arthrogryposis. When applied to carefully selected patients, anterior distal hemiepiphysiodesis of the tibia is an effective method for management of recurrent equinus deformity.
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Affiliation(s)
- Ramin Zargarbashi
- Associate Professor, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Abdi
- Assistant Professor, Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Bozorgmanesh
- Surgeon, Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Behnam Panjavi
- Associate Professor, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Associate Professor, Imam Reza Hospital, Birjand University of Medical Sciences, Birjand, Iran
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Murtaza K, Saleem Z, Malik S. Talipes equinovarus or Clubfoot: A review of study approaches, management and trends in Pakistan. Pak J Med Sci 2020; 36:1414-1420. [PMID: 32968421 PMCID: PMC7501030 DOI: 10.12669/pjms.36.6.2514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This paper aims to assess the status of scientific literature on talipes equinovarus (TEV) published from Pakistan, to get an insight into the trend in knowledge over the years, and to highlight study gaps in this area. A detailed review of published literature was conducted from November 2019 to January 2020. ‘Talipes/congenital talipes’, ‘clubfoot/congenital clubfoot’, ‘talipes equinovarus /congenital talipes equinovarus’ AND ‘Pakistan’ were used as key terms. Different search engines, PubMed, PakMediNet, ScienceDirect, Embase and Google Scholar were utilized to retrieve articles. A total of 63 articles were retrieved. The hotspot of TEV research in Pakistan has been its treatment and management. Over the years, treatment trend has shifted from operative to conservative; Ponseti method is predominantly employed. Hospital-based studies focusing on pediatric patients are common while population-based studies are devoid. In majority of cohorts, there is preponderance of male patients, idiopathic and unilateral cases. There is, however, scarcity of basic research on the prevalence, etiology, risk factors, clinical heterogeneity, associated anomalies, genetics, and molecular diagnostics of TEV. In conclusion, prudent scientific evidence is required for any policy-making and relevant public health action. Hence, large scale population-based studies are required for a broader overview and understanding the clinical spectrum of TEV.
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Affiliation(s)
- Khadija Murtaza
- Khadija Murtaza, Human Genetics Program, Department of Zoology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Zahra Saleem
- Zahra Saleem, Human Genetics Program, Department of Zoology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Sajid Malik
- Sajid Malik, Human Genetics Program, Department of Zoology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
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Prediction of Number of Casts and Need of Tenotomy Using Pirani Score in the Management of Clubfoot. J Craniofac Surg 2019; 30:e477-e481. [PMID: 31299821 DOI: 10.1097/scs.0000000000005571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Clubfoot also called as congenital tailpipes equinovarus is a complex ankle and foot deformity characterized by forefoot adduction and supination, midfoot cavus and hindfoot varus and equinus. It is estimated that more than 100,000 babies are born each year worldwide with clubfoot, and 80% are seen in developing nations. Different scoring systems are used for grading the severity of deformity or monitoring the natural history of clubfoot. The Pirani scoring system is now routinely used in most clubfoot clinics, including Cure Ethiopia, Children's Hospital. METHODS A facility based retrospective study was conducted on 278 idiopathic club feet successfully treated by the Ponseti method and scored by Pirani system between September 2013/14 to September 2017/2018. Age at presentation, number of casts required, need for percutaneous Achilles tenotomy, casting effects were recorded. RESULTS A total of 287 clinical folders of children were retrieved (424 feet). The mean (±SD) number of casts required for correction of the deformity was 5.54 ± 1.63. The number of cast required for correction is significantly, and positively correlated with initial severity of Pirani score (r = 0.62 for right foot; r = 0.675 for left foot). There is a significant difference on the overall initial Pirani score between tenotomy and non- tenotomy group (P value < 0.001). CONCLUSION The study revealed that severity of initial Pirani score can be used to estimate the number of Ponseti cast required for correction of clubfoot deformity and the need for tenotomy. Besides, the number of Ponseti cast required may not be affected by age of a child at the commencement of treatment.
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Sun JX, Yang ZY, Xie LM, Wang B, Bai N, Cai AL. TAZ and myostatin involved in muscle atrophy of congenital neurogenic clubfoot. World J Clin Cases 2019; 7:2238-2246. [PMID: 31531318 PMCID: PMC6718803 DOI: 10.12998/wjcc.v7.i16.2238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/23/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Muscular atrophy is the basic defect of neurogenic clubfoot. Muscle atrophy of clubfoot needs more scientific and reasonable imaging measurement parameters to evaluate. The Hippo pathway and myostatin pathway may be directly correlated in myogenesis. In this study, we will use congenital neurogenic clubfoot muscle atrophy model to verify in vivo. Further, the antagonistic mechanism of TAZ on myostatin was studied in the C2C12 cell differentiation model.
AIM To identify muscle atrophy in fetal neurogenic clubfoot by ultrasound imaging and detect the expression of TAZ and myostatin in gastrocnemius muscle. To elucidate the possible mechanisms by which TAZ antagonizes myostatin-induced atrophy in an in vitro cell model.
METHODS Muscle atrophy in eight cases of fetal unilateral clubfoot with nervous system abnormalities was identified by 2D and 3D ultrasound. Western blotting and immunostaining were performed to detect expression of myostatin and TAZ. TAZ overexpression in C2C12 myotubes and the expression of associated proteins were analyzed by western blotting.
RESULTS The maximum cross-sectional area of the fetal clubfoot on the varus side was reduced compared to the contralateral side. Myostatin was elevated in the atrophied gastrocnemius muscle, while TAZ expression was decreased. They were negatively correlated. TAZ overexpression reversed the diameter reduction of the myotube, downregulated phosphorylated Akt, and increased the expression of forkhead box O4 induced by myostatin.
CONCLUSION Ultrasound can detect muscle atrophy of fetal clubfoot. TAZ and myostatin are involved in the pathological process of neurogenic clubfoot muscle atrophy. TAZ antagonizes myostatin-induced myotube atrophy, potentially through regulation of the Akt/forkhead box O4 signaling pathway.
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Affiliation(s)
- Jia-Xing Sun
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Ze-Yu Yang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Li-Mei Xie
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Bing Wang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Ning Bai
- Key Laboratory of Medical Cell Biology, Ministry of Education; Institute of Translational Medicine, China Medical University, Liaoning Province Collaborative Innovation Center of Aging Related Disease Diagnosis and Treatment and Prevention, Shenyang 110004, Liaoning Province, China
| | - Ai-Lu Cai
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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Kadia BM, Aroke D, Tianyi FL, Bechem NN, Dimala CA. Spina bifida cystica and severe congenital bilateral talipes equinovarus in one twin of a monoamniotic pair: a case report. BMC Res Notes 2017; 10:771. [PMID: 29282147 PMCID: PMC5745804 DOI: 10.1186/s13104-017-3108-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/20/2017] [Indexed: 09/15/2023] Open
Abstract
Background Spina bifida and congenital talipes equinovarus (CTEV) are common congenital malformations which may occur together and increase morbidity. Monozygous twins are particularly at risk of these malformations and discordance in one type of malformation is typical. The occurrence of both spina bifida and CTEV in one twin of a monozygotic pair is rare. Case presentation A 22 year-old Cameroonian primigravida at 36 weeks of a twin gestation was received in our district hospital at the expulsive phase of labour on a background of sub-optimal antenatal care. A caesarean section indicated for cephalo-pelvic disproportion was performed and life monoamniotic male twins were extracted. The first twin was normal. The second twin had spina bifida cystica and severe bilateral CTEV. Routine postnatal care was ensured and at day 2 of life, the affected twin was evacuated to a tertiary hospital for proper management. He was later on reported dead from complications of hydrocephalus. Conclusions Spina bifida cystica with severe bilateral CTEV in one twin of a monoamniotic pair illustrates the complexity in the interplay of causal factors of these malformations even among monozygotic twins who are assumed to share similar genetic and environmental features. The occurrence and poor outcome of the malformations was probably potentiated by poor antenatal care. With postnatal diagnoses, a better outcome was difficult to secure even with prompt referral. Early prenatal diagnoses and appropriate counseling of parents are cardinal.
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Affiliation(s)
- Benjamin Momo Kadia
- Foumbot District Hospital, Foumbot, Cameroon.,Grace Community Health and Development Association, Kumba, Cameroon
| | - Desmond Aroke
- Health and Human Development (2HD) Research Network, Douala, Cameroon. .,Mbengwi District Hospital, Mbengwi, Cameroon.
| | | | | | - Christian Akem Dimala
- Health and Human Development (2HD) Research Network, Douala, Cameroon.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Orthopaedics, Southend University Hospital, Essex, UK
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Balasankar G, Luximon A, Al-Jumaily A. Current conservative management and classification of club foot: A review. J Pediatr Rehabil Med 2016; 9:257-264. [PMID: 27935562 DOI: 10.3233/prm-160394] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Clubfoot, known as congenital talipes equinovarus, is one of the complex paediatric foot deformity with the incidence of 1 in every 1000 live births. It consists of four complex foot abnormalities such as forefoot adductus, midfoot cavus, and hindfoot varus and ankle equinus. There are a number of surgical techniques (soft tissue releases, arthrodesis) used to correct clubfoot. However currently the conservative management (manipulation, serial casting, and braces) of clubfoot is considered as the best choice and it is widely accepted among orthopaedists. Clubfoot treated with surgical techniques might suffer various complications such as soft tissues contractures, neurovascular complications, infections, and shortening of the limbs. Although conservative method is generally considered as an effective method, it is still challenging to cure clubfoot in advance stages. Also, the classification of the initial severity of clubfoot is essential to evaluate the outcome of the treatment. In this review, the aim is to review the different types of conservative method and the assessment of clubfoot severity.
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Affiliation(s)
| | | | - Adel Al-Jumaily
- Department of FEIT, University of Technology Sydney, NSW, Australia
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