Histochemical Studies in Congenital Clubfeet

Kojima, Atsuo; Nakahara, Hiroyuki; Shimizu, Nobuhiro; Taga, Ichiro; Ono, Katsuhiko; Nonaka, Ikuya; Hiroshima, Kazuo

doi:10.1007/978-1-4613-9269-9_4

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Morphometric studies found a predominance of type I fiber in muscles involved in the formation of clubfoot (mainly Mm. gastrocnemii), leading to type II fiber deficiency25,26 responsible for small calves in these patients. This deficit could also be responsible for relapses in clubfoot because correction surgeries do not eliminate this imbalance.…”

Section: Discussionmentioning

confidence: 99%

The congenital clubfoot – immunohistological analysis of the extracellular matrix

Kerling

Stoltenburg‐Didinger

Grams

et al. 2018

ORR

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Purpose: Congenital clubfoot is one of the most common limb disorders in humans and its etiology is still unclear. In order to better understand the pathogenesis of patients with primary clubfoot, we examined whether there are quantitative changes in the extracellular matrix (ECM; based on common interstitial collagens [C] like CI and CIII, microfilamentous collagens like CVI, noncollagenous proteins like undulin, and enzymes like matrixmetalloproteinase [MMP]-2 and tissue inhibitor of matrixmetalloproteinase [TIMP]-2 that are known to play a role in fibrogenesis and fibrolysis) of muscles involved in the foot deformity of patients with primary clubfoot corresponding to fibrosis. Patients and methods: Thirty patients (age ranging from 4 months to 5 years and 7 months) with primary clubfoot were examined (23 male and 7 female patients), among whom 18 patients were affected on one side and 12 affected on both sides. Twenty-five biopsies were taken during the first operative foot correction (Crawford-McKay) and 5 in the context of relapses. Muscle biopsies were taken from the muscles involved in the defect (Musculus [M.] gastrocnemius and M. tibialis anterior) and from the M. vastus lateralis of the M. quadriceps femoris, which were treated as healthy comparison muscles. Quantitative analysis of the components of the ECM was performed using a computer-assisted fibrosis measurement of the immunohistochemically processed tissue samples. Results: We found higher values for M. gastrocnemius for CI, CIII, CVI and undulin in comparison with M. vastus lateralis. However, values for TIMP-2 were reduced. We found no significant differences for the components of M. tibialis anterior and M. vastus lateralis. There were no quantitative differences between male and female or between patients affected on one side and both sides. In patients who underwent relapse surgery, CI, CIII, CVI, and undulin of the gastrocnemius were significantly higher, while TIMP-2 was significantly lower. Conclusion:In the present study, we found manifest fibrosis in gastrocnemius due to quantitative changes in the ECM. In contrast to other studies, we found increasing fibrosis not just in contracted tissues but also in the muscle itself. Further studies are needed to clarify whether these changes are primarily responsible for the malfunction or whether they occur secondarily in the consequence of the dysfunction. Keywords: pes equinovarus, clubfoot, extracellular matrix, fibrosis, collagens, TIMP-2 IntroductionCongenital clubfoot is one of the most common limb disorders in humans with a prevalence of 1-2/1000 live births among Caucasians.1 The deformity appears with an adductus of the forefoot, a cavus of the midfoot, and an equinovarus of the hindfoot, for which there is a wide variation in clinical severity.2 There are many theories

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Section: Discussionmentioning

confidence: 99%

The congenital clubfoot – immunohistological analysis of the extracellular matrix

Kerling

Stoltenburg‐Didinger

Grams

et al. 2018

ORR

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show abstract

“…Thus, casting would result in reversible atrophy that would not persist, not to mention increase (1). Literature suggests the neuromuscular origin as the possible pathological cause of persistent, progressing and untreatable atrophy (10)(11)(12)(13)(14). Still, others think that it is the pro-portion of muscle fi ber types (types I and II) that changes, as they found a relative increase in type I fi bers on the affected side (5,10,11,(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Lower leg atrophy in congenital talipes equinovarus

Beke

Leidecker²,

Koch³

et al. 2014

Paediatr Croat

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Histochemical Studies in Congenital Clubfeet

Cited by 2 publications

References 15 publications

The congenital clubfoot – immunohistological analysis of the extracellular matrix

The congenital clubfoot – immunohistological analysis of the extracellular matrix

Lower leg atrophy in congenital talipes equinovarus

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Histochemical Studies in Congenital Clubfeet

Cited by 2 publications

References 15 publications

The congenital clubfoot &ndash; immunohistological analysis of the extracellular matrix

The congenital clubfoot &ndash; immunohistological analysis of the extracellular matrix

Lower leg atrophy in congenital talipes equinovarus

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The congenital clubfoot – immunohistological analysis of the extracellular matrix

The congenital clubfoot – immunohistological analysis of the extracellular matrix