Lower leg atrophy in congenital talipes equinovarus

Although several authors have addressed calf atrophy, there is no study comparing cases with a sizable control group or describing the development of healthy calf musculature. Keeping in mind the neuromuscular origin of clubfoot, the authors aimed to fi nd out whether the “unaff ected” foot is really unaff ected in the unilateral clubfoot, and whether its circumference fails to reach the expected measure. The authors examined 60 clubfeet of 40 cases (mean age: 18, range: 3-30 years) and recorded their body weight, height, lower leg length and circumference. To record the same values in healthy controls, the same person examined 1086 feet of 543 subjects aged 4-22 (mean age: 12.5 years). According to the measured values, lower leg length strongly correlates with body height and circumference with body weight. This means the most important developmental trends of these parameters can be demonstrated with polynomial regression models. In unilateral clubfoot, the mean diff erence in lower leg length and circumference between the aff ected and unaff ected leg was 0.86 cm and 3.13 cm, respectively. Atrophy of the unaff ected leg can be justifi ed at 10% signifi cance level. In the case of bilateral clubfoot, the diff erence in length and circumference is justifi ed by numerical results. By recording lower leg length and circumference in controls, the authors pioneered documenting the parameters of healthy calf muscle development. These data can be used to determine the rate of developmental failure in bilateral clubfoot and to reveal the possible involvement of the unaff ected leg in unilateral clubfoot.

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