A Vascular Hypothesis for the Etiology of Clubfoot

Maternal smoking and the risk for clubfoot in infants

“…The etiology of clubfoot is not well understood but numerous causes have been proposed. Intrauterine compression, vascular insufficiency, breech position, abnormal myogenesis, intrauterine infection, and neurologic abnormalities are several of the mechanistic theories suggested (Kite, 1964; Wynne‐Davies, 1972; Hootnick et al, 1994; Martin et al, 1994; Mellerowicz et al, 1994). Genetic factors are also thought to play a role (Wynne‐Davies, 1972; de Andrade et al, 1998; Lochmiller et al, 1998; Honein et al, 2000; Dietz, 2002).…”

Idiopathic talipes equinovarus (ITEV) (clubfeet) in Texas

“…The etiology of ITEV is not known but a number of causes have been suggested including intrauterine compression, abnormal myogenesis, neurologic abnormalities, vascular insufficiency, and genetic factors [Kite, 1964a,b; Wynne‐Davies, 1964, 1972; Rebbeck et al, 1993; Hootnick et al, 1994; Martin et al, 1994; Mellerowicz et al, 1994; de Andrade et al, 1998; Lochmiller et al, 1998; Dietz, 2002]. Segregation analyses and family studies provide strong support for the role of genetic factors [Rebbeck et al, 1993; de Andrade et al, 1998; Lochmiller et al, 1998].…”

Letter to the editor

“…Therefore, it is not necessary to impute theoretical models of ZPA loss or postaxial hypoplasia in the causation of this entity. We have revealed that aberrant vasculogenesis in the six-week embryo is almost uniformly associated with these birth defects [6]. Further, it is possible to explain much of the bony pathomechanics in terms of abnormal vasculogenesis.…”