Handbook of congenital malformations / edited by Alan Rubin.

Date:
1967
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Handbook of congenital malformations / edited by Alan Rubin. Source: Wellcome Collection.

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    CLUBFOOT (Talipes). Most typical clubfoot is talipes equinovarus, in which heel is inverted, forefoot supinated and ankle plantar flexed. Second most common type is talipes calcaneovalgus, in which the foot is everted and the ankle dorsiflexed. Bilateral in about half the cases. Prevalence: 1 in 1000 to 1500. Two affected males to every female. Associated Anomalies: Spinal defects and neurologic impairment. Hereditary Factors: There is a noninherited type, in which the re¬ currence risk is no greater than in the general population. The in¬ herited type has a recurrence risk of 10 per cent and seems to be an autosomal dominant with 40 per cent penetrance. Treatment and Outlook: Corrective casts and splints. Surgery of the soft tissue and bone structures is indicated in recurrent or refrac¬ tory cases. In the milder cases a normal foot will result. In severe cases some residual deformity is anticipated. Once growth is attained no further recurrence or deformity occurs. Reference: Palmer, R. M.: The genetics of talipes equinovarus. J. Bone & Joint Surg. 46-A:542,1964. COXA VARA. A decrease of the angle between the neck of the femur and the shaft often associated with a defect in the neck of the femur. The condition is usually bilateral and may not be recognized until walking begins, when a limp is noted. Prevalence: Unknown. Associated Anomalies: Frequently associated with femoral dys¬ genesis and often regarded as a component of that condition. Hereditary Factors: None apparent. Treatment and Outlook: Osteotomy of the femur corrects the angular deformity and favors healing of the defect. Effective therapy leads to full function. Reference: Bable, F. S., Ghormley, R. К., and Chatterton, С. С.: Congenital coxa vara. J. Bone & Joint Surg. 31-A:115, 1949. CRANIOSTENOSIS. See page 90. DUPUYTREN'S CONTRACTURE. Fibrous nodules of the palmar fascia of the hand which involute and cause scarring. The overlying fat is replaced by scar tissue, which is adherent to the skin. Contractures of the fourth and fifth fingers are most common. Occasionally other fingers are involved. The condition is usually bilateral. The complete diathesis includes plantar fibroma, thickening of the fascia of the penis (Peyronie's disease) and knuckle pads. See also under Camptodactyly, page 55. Prevalence: Increases with age and is higher in men. Among epileptics the incidence is high and the disease more severe. Associated Anomalies: Periarthritis of the shoulder. 58