Clinical Implications of Clubfoot Histopathology

    loading  Checking for direct PDF access through Ovid



Ipsilateral peroneus brevis muscle histopathology was studied in 64 children with idiopathic rigid equinovarus at the setting of initial posteromedial-lateral release. Fifty percent of biopsies demonstrated abnormal muscle fiber morphology, classified as congenital fiber-type disproportion or fiber-size variation. Forty-one infants (59 feet) underwent initial surgical intervention within the first year of life with a minimum 2-year follow-up. Feet with abnormal muscle histology had a significantly greater incidence of recurrent equinovarus deformity requiring reoperation; the relative risk of clubfoot recurrence in children with fiber abnormalities was 5.6. Male patients with bilateral deformity and abnormal peroneus brevis histology had a particularly high incidence of recurrent equinovarus. Developmental internal tibial torsion requiring surgical intervention was also greater in the abnormal-fiber histology group. The incidence of postoperative metatarsus adductus/varus necessitating surgery was comparable despite histologic findings. Thus muscle-fiber abnormalities are prevalent in idiopathic equinovarus. Such fiber-type anomalies may predict recurrent limb deformities.

Related Topics

    loading  Loading Related Articles