Genetic and Epidemiological Studies of Clubfoot in Hawaii

Chung, C. S.; Nemechek, R W; Larsen, I.J.; Ching, G H

doi:10.1159/000152236

Cited by 125 publications

(129 citation statements)

References 4 publications

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“…Orthopaedic conditions commonly present bilaterally [1,6,14,19]. In clinical trials, data from each limb are commonly treated as independent [10,13].…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Clubfeet Are Highly Correlated: A Cautionary Tale for Researchers

Gray

Gibbons

Little

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Congenital talipes equinovarus, or clubfoot, is a common pediatric orthopaedic condition of unknown origin. In many clubfoot clinical trials, interventions are assigned to a patient, but response to treatment is assessed separately in each foot. Trials commonly report x patients with y feet where y is greater than x (eg, 35 patients with 56 feet). However, common statistical tests assume that each data point is independent. Although data from unilateral cases of clubfoot are independent, it is unknown if each foot of patients with bilateral clubfeet are correlated. Questions/purposes The purpose of this study was to assess the correlation in the feet of patients with bilateral clubfeet by (1) evaluating the degree of severity between lower limbs of each patient with bilateral clubfeet at baseline; (2) determining if right and left feet of each patient responded to intervention in the same way; (3) determining the proportion of bilateral relapse; and (4) determining the proportion of right and left feet which required the same intervention to correct bilateral relapse. Methods We performed a chart review of the records of 33 patients with bilateral clubfeet (66 feet). Baseline severity was assessed using the Pirani score. The number of Ponseti serial casts to correct the deformity, the proportion of patients who underwent bilateral Achilles tenotomy, the proportion of bilateral relapse, and the treatment to correct bilateral relapse were examined. Results The degree of severity between right (Pirani score mean, 5.2; SD, 0.8) and left (Pirani score mean, 5.2; SD, 0.5) feet for each patient at baseline was highly correlated (r = 0.76, p \ 0.001). Response to intervention between lower limbs was highly correlated for the number of Ponseti casts required for initial correction (right mean, 5.2, SD, 1.1; left mean, 5.2, SD, 1.3) (r = 0.89, p \ 0.001) and the proportion of patients who underwent bilateral Achilles tenotomy (right, 17/18; left, 16/18) (r = 0.94, p \ 0.001). In the nine patients who experienced relapse, eight experienced bilateral involvement. In all cases of bilateral relapse, the right and left foot of each patient required the same intervention to correct the relapse. Conclusions In patients with bilateral clubfeet, baseline severity, response to initial Ponseti treatment, Achilles tenotomy, and relapse outcomes were highly correlated in

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“…Orthopaedic conditions commonly present bilaterally [1,6,14,19]. In clinical trials, data from each limb are commonly treated as independent [10,13].…”

Section: Discussionmentioning

confidence: 99%

“…Orthopaedic conditions, such as clubfoot often present bilaterally [1,4,6,14,19]. Orthopaedic research commonly involves analysis of populations of patients with bilateral presentations.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Clubfeet Are Highly Correlated: A Cautionary Tale for Researchers

Gray

Gibbons

Little

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…While it is becoming more clear that clubfoot is multifactorial in origin, genetic factors clearly play a role as suggested by the 33% concordance of identical twins and the fact that nearly 25% of all cases are familial [44]. Additional evidence for a genetic etiology is provided by differences in clubfoot prevalence across ethnic populations with the lowest prevalence in Chinese (0.39 cases per 1000 live births) and the highest in Hawaiians and Maoris (seven per 1000) [5,13]. Though the exact genetic mechanism of clubfoot has not yet been determined, a multifactorial and possibly polygenic causation has been suggested [44,75].…”

Section: Etiologymentioning

confidence: 99%

Update on Clubfoot: Etiology and Treatment

Dobbs

Gurnett²

2009

Clinical Orthopaedics &Amp; Related Research

265

260

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“…PEV, 1000 canlı doğumda 1-2 arası sayıda görülmekle beraber, Çinlilerde binde 0,39 oranıyla en düşük, Havai ve Maori popülas-yonunda 1000 canlı doğumda 7 ile en yüksek oranda görülmektedir. [19,20] İzole PEV için erkek/kadın oranı 2/1 olup, farklı etnik gruplarda bu oran değişmemiştir. Genetik mekanizma tam olarak çözümlenmiş değildir.…”

Section: Embri̇yoloji̇k çAlişmalarunclassified

Doğuştan çarpık ayak etiyolojisi

Altay¹,

Çetin²

2015

TOTBID

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Genetic and Epidemiological Studies of Clubfoot in Hawaii

Cited by 125 publications

References 4 publications

Bilateral Clubfeet Are Highly Correlated: A Cautionary Tale for Researchers

Bilateral Clubfeet Are Highly Correlated: A Cautionary Tale for Researchers

Update on Clubfoot: Etiology and Treatment

Doğuştan çarpık ayak etiyolojisi

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