Pathology
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Fetopathology and developmental pathology of the embryo and fetus
Marta Ježová, Josef Feit et al.
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Club foot
Introduction

Complex deformity of the foot which consists or equinus (the foot in plantar flexion), varus, forefoot adduction and inversion, cavus deformity. From the word equinus meaning like a horse.

Clinical signs
  • incidence in general population is 1 per 1000 live births
  • male to female ratio is 2:1
  • 20% of affected children have severe coexisting malformations  —  spina bifida, trisomy 18 and various genetic syndromes
  • idiopathic club foot in an otherwise healthy child is probably the result of multifactorial traif of inheritance. A higer incidence of club foot is noted in patiens with positive family history
Etiology, pathogenesis

True etiology remains unknown despite several theories:

  • arrest of fetal developement
  • neurogenic factors
  • mechanical factors  —  external uterine compression in oligohydramnion
  • defective cartilaginous anlage of the talus
  • prenatal poliomyelitis-like infection
  • Postural or positional  —  f.e. due to oligohydramnion, correctable without surgary
  • True club foot (rigid)  —  surgary is required
  • Club foot associated with arthrogryposis
  • Club foot associated with syndromes and neuromuscular disorders (spina bifida)
Macroscopic appearance

The person walks on the outer part of the sole, the heel is upward. The foot is smaller than normal, musles of the calf are hypotrophic.

40 % cases are bilateral.