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Clubfoot deformity in Down's syndrome

P R Miller1, K N Kuo, J P Lubicky

  • 1Shriners Hospital for Crippled Children, Chicago, Ill 60635, USA.

Orthopedics
|May 1, 1995
PubMed
Summary

Clubfeet in Down's syndrome (trisomy 21) often resist nonoperative treatment. Surgical intervention is frequently required and yields acceptable outcomes for this orthopedic condition.

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Area of Science:

  • Orthopedics
  • Genetics
  • Pediatrics

Background:

  • Down's syndrome (trisomy 21) is a genetic disorder.
  • The association between Down's syndrome and clubfeet requires further elaboration.
  • Clubfoot is a common congenital foot deformity.

Observation:

  • Eight patients with Down's syndrome and 15 clubfeet were reviewed.
  • Five patients had confirmed trisomy 21, one had mosaic Down's syndrome.
  • Two patients presented with characteristic Down's syndrome features without chromosomal documentation.
  • Two patients had concurrent arthrogryposis and Down's syndrome.
  • Four patients exhibited additional orthopedic anomalies.

Findings:

  • All 15 clubfeet initially underwent casting.
  • Fourteen of the 15 clubfeet required surgical intervention for correction.
  • Long-term follow-up (average 5 years) for 6 feet showed 1 excellent, 4 good, and 1 fair result.
  • Clubfeet associated with Down's syndrome appear resistant to nonoperative management.

Implications:

  • Surgical treatment for clubfeet in Down's syndrome patients appears effective.
  • This study highlights the complexity of orthopedic management in children with Down's syndrome.
  • Further research is warranted to understand the specific challenges and optimal treatment strategies for clubfeet in this population.

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