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Anatomical study for an updated comprehension of clubfoot. Part II: Ligaments, tendons and muscles.
MedLine Citation:
PMID:  19308510     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: The aim of our study was to evaluate the pathological anatomy of the ligaments, tendons and muscles in clubfeet, and to show whether the dysbalance of shortened and elongated structures is an adaptive process or a primary factor inducing the misshaped bones and cartilagines.
METHODS: Surgical exposure was performed on seven idiopathic clubfeet specimens, aborted between the 25th and 37th week of gestation and compared to two normal feet (27th and 36th week of gestation).
RESULTS: The medial stabilisation system of the foot was found shortened, but all ligaments could be dissected. On the lateral side, the calcaneofibular ligament in particular was both 'shortened' and 'elongated', depending on the course of the fibres to the axis of motion in the subtalar and talocalcaneonavicular joint. The main difference to the normal feet was found in the thickened tendon of the tibialis posterior forming a bulbus before dividing into fascicules.
CONCLUSIONS: We presume the ossification disturbance of the calcaneus to be the primary fault. This disturbance will influence the reduction of the varus position, so ligaments and tendons will be conformed to the misshaped bones.
Authors:
Gunther Windisch; Friedrich Anderhuber; Verena Haldi-Brändle; Gerhard Ulrich Exner
Publication Detail:
Type:  Journal Article     Date:  2007-01-04
Journal Detail:
Title:  Journal of children's orthopaedics     Volume:  1     ISSN:  1863-2521     ISO Abbreviation:  J Child Orthop     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2009-03-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101313582     Medline TA:  J Child Orthop     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  79-85     Citation Subset:  -    
Affiliation:
Institute of Anatomy, Medical University Graz, Harrachgasse 21, 8010, Graz, Austria, gunther.windisch@meduni-graz.at.
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