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Purpose We measured the foot size and shoulder width in North Indian children with idiopathic clubfoot and calculated the corresponding metal rod length for abduction brace. The differences in the foot length in unaffected, unilateral and bilateral clubfeet were also measured. Patient and methods Two sets of measurements were taken on each child: feet size and shoulder width. Using statistical analysis, the following were compared: Differences in the manual prescribed and our calculated SFAB bar length, foot size in unilateral clubfoot and unaffected foot and both feet in bilateral clubfoot. Results There were 156 patients with 76 unilateral (37 left + 39 right) and 80 bilateral feet. The mean prescribed bar length for foot sizes 8-14 in the Steenbeek manual is 30.18 cm. The mean predicted bar length worked out to be 22.33 cm in our series (p

Background Clubfeet and constriction band syndrome is a very rare non-idiopathic condition. Treatment is often difficult and the recurrence deformity rate is high. The purpose of this study was to assess the effectiveness of Ponseti method in the treatment of congenital constriction band syndrome accompanied by clubfoot deformity and lymphedema. Case presentation We are presenting an interesting case of bilateral clubfeet and congenital circumferential constriction band syndrome in the lower limb. Ponseti method of correcting the congenital clubfoot deformity was applied. Constriction band release is accomplished by two stages completely excising the fibrous band and multiple two-stage Z-plasties on the right calf. Conclusion The results of this study indicate that the Ponseti method of gentle, systematic manipulation and weekly cast changes is an effective treatment of non-idiopathic clubfoot distal to congenital amniotic constriction band.

Introduction: We measured the foot dimensions in the Ponseti treated idiopathic clubfeet to compare differences in foot sizes, if any. Patient and Methods: The foot length and width in unaffected, unilateral and bilateral clubfeet were measured and analysed statistically. Results: Average follow up was 22.2 months. Bilateral feet were similar in size. The unilateral affected feet matched in size with contralateral unaffected feet. The size difference between bilateral and unilateral affected feet was not significant. The bilateral feet were significantly smaller than age matched unaffected feet [in length 0.8 cm (6.1%); p = 0.03 and in width 0.2 cm, (3.7%); p = 0.03]. The unilateral foot was comparable with contralateral unaffected foot both during and post bracing. Conclusions: Post Ponseti treatment, inter bilateral, unilateral affected versus unaffected, bilateral versus unilateral affected feet matched in size. The overall clubfeet size especially those with bilateral disease were significantly shorter than unaffected side. The Ponseti managed unilateral foot size was comparable with unaffected foot during the bracing duration and size comparability was maintained even after bracing protocol of 3 years was over.

Little has been reported on fetal diagnosis of choroidal fissure cysts and prediction of the clinical complications that can result. We describe the case of a near-term male infant with prenatally diagnosed choroidal fissure cyst and bilateral clubfeet. His prolonged course in the neonatal intensive care nursery was marked by severe panhypopituitarism, late-onset diabetes insipidus, placement of a cystoperitoneal shunt, and episodes of sepsis. Postnatal genetic evaluation also revealed an interstitial deletion involving most of band 10q26.12 and the proximal half of band 10q26.13. The patient had multiple readmissions for medical and surgical indications and died at 6 months of age. This case represents the severe end of the spectrum of medical complications for children with choroidal fissure cysts. It highlights not only the importance of comprehensive evaluation and multidisciplinary management and counseling in such cases, but also the need for heightened vigilance in these patients.

A 16-month-old male with previously untreated bilateral clubfeet was admitted to S.B. Izmir Tepecik Education and Research Hospital, Izmir, Turkey. Both feet underwent surgical treatment. During surgery, an accessory soleus muscle was detected on the right side. The accessory soleus muscle had a distinct distal insertion at the superior anteromedial border of the calcaneus and also anterior and medial to the Achilles tendon. He was treated by bilateral complete subtalar release with Cincinnati incision, and the accessory soleus was also cut and the distal part resected. At the final follow-up visit, when the patient was 6 years and 9 months old, both feet had a normal appearance and appeared normal on radiograph and magnetic resonance imaging, with no presence of the accessory soleus muscle or its remnant. In our opinion, awareness of the association between an accessory soleus muscle and clubfoot, and sectioning of this muscle during surgery may improve surgical results. (J Am Podiatr Med Assoc 98(5): 408–413, 2008)

Bilateral symmetrical Achilles tendon ossification is presented, with a fracture on one side. A 57 year old male patient was conservatively treated for bilateral clubfeet in his childhood. Part of his Achilles tendons were replaced by ectopic bony mass and on the left it fractured without any trauma. The fracture was treated surgically by vertical thinning, intraosseal suture “osteosynthesis”, and tendon flap plasty. This pathological condition healed in three months. Seven years after the operation the X-ray revealed total bony rebuilding. The ectopic bone mass has the same biological behaviour as the anatomic bones.

We present the case of an 18-month-old boy with dysmorphic facial features, developmental delay, growth retardation, bilateral clubfeet, thrombocytopenia, and strabismus, whose array CGH analysis revealed concurrentde novotrisomy 10p11.22p15.3 and monosomy 7p22.3. We describe the patient's clinical presentation, along with his cytogenetic analysis, and we compare the findings to those of similar case reports in the literature. We also perform a bioinformatic analysis in the chromosomal regions of segmental aneuploidy to find genes that could potentially explain the patient's phenotype.

Objective To describe an 8 year old girl, with a new autosomal recessive syndrome presenting with severe dystonia and on MRI a unique pattern of infolded polymicrogyria. Methods An 8 year old girl is the product of consanguineous Arab-Moslem parents. Prenatal ultrasound demonstrated bilateral clubfeet. She achieved walking at the age of 5.5 years but has no speech. On examination she demonstrates:generalized dystonia, hypotonia with muscle wasting, clubfeet, and a a pseudobulbar syndrome with no expressive speech but good comprehension. Results MRI shows a unique pattern of bilateral infolded extensive perisylvian polymicrogyria. The findings are more prominent on the right side and do not resemble the classical patterns of polymicrogyria. Conclusion To date there is no description of this unique pattern of imaging of perisylvian polymicrogyria. The inheritance of classical bilateral perislvian polymicrogyria is mostly autosomal dominant and this syndrome is assumed to be autosomal recessive due to parental consanguinity. The severe movement disorder in our case has not been mentioned in other perisylvian syndromes.

The article ‘‘Bilateral Clubfeet Are Highly Correlated: A Cautionary Tale for Researchers’’ (Clin Orthop Relat Res 2014, epub ahead of print, DOI 10.1007/s11999-014-3776-6) contained important areas of overlap with the article ‘‘Unilateral Versus Bilateral Clubfoot: An Analysis of Severity and Correlation,’’ which was published in a volume of the Journal of Pediatric Orthopaedics (British) (2014, 23:397–399). This was not made clear in the CORR article. In particular, 26 of the 33 patients whose data were included in the study published in CORR were included in the earlier work published in Journal of Pediatric Orthopaedics (British). This is particularly relevant to the question of clubfoot severity at the time of patient presentation, which was studied in both papers. The authors regret that they did not make this clear in the later publication in CORR.

We report on a 32-year-old Italian man, his 5-year-old daughter, and his 3 1/2-year-old son, all of whom had congenital joint contractures. Each has severe ulnar deviation of fingers and soft-tissue contractures of both hands; and each had bilateral clubfeet at birth. The father is short in stature, as are the children, who also have delayed carpal ossification. The findings in this family suggest autosomal-dominant inheritance of the condition. The clinical features are consistent with the condition currently referred to as "distal" arthrogryposis.

ObjectivesThe purpose of this study was to determine the compliance of parents of children with clubfeet treated with the Ponseti method and to identify factors that may predict brace non-compliance.MethodsA myriad of factors affecting families' compliance were assessed by administering questionnaires to 108 patients with clubfoot from December 2009 to January 2012. The family's demographic data, including monthly income, educational level of the parents, number of children in the family, and other factors, were studied and statistically analysed.ResultsAll 108 patients had severe clubfoot. The parents of 72 (66.7%) patients complied with the use of the brace compared to 36 (33.3%) parents who did not comply. Unilateral clubfoot was a significant risk factor for non-compliant parents compared to bilateral clubfeet (p = 0.05). Parents with 3 or more children had more non-compliance (66.7%) compared to those with less than 3 children (38.9%). All non-compliant parents reported that their babies cried during the application of the brace in contrast to 25% of the complaint parents (p

worker in Puerto Rico in 1947, a colleague from a nearby town referred a case to her that she still remembers vividly. It ex emplifies a principle as vital today as it was twenty-five years ago. The 4-year-old boy who could not walk unless he clung to the walls was known to everyone as el corino, the clubfoot. He had been receiving plaster-cast treatment for severe bilateral clubfeet under the Crip pled Children Bureau in a district hospital. After three months his father had removed the cast, had refused to continue treatment, and had forbidden the mother to intervene.