Associations of intracompartmental leg pressures and radiographic findings in congenital talipes equinovarus.

The etiopathogenesis of congenital talipes equinovarus remains mysterious. The authors investigated the role of increased intracompartmental leg pressures as a causal relationship with this deformity by measuring the pressures in 25 children aged between 6 months and 1 year with unilateral talipes equinivarus before surgical release. The deep posterior intracompartmental pressure in the leg with talipes equinovarus was greater than the other compartments, and the deep and superficial posterior intracompartmental pressures were also significantly higher than those of the contralateral normal sides (p < 0.05). There were linear correlations between the posterior intracompartmental pressure of affected legs and the Kite index, tibiocalcaneal angle and talo-first metatarsal angle of the affected legs. Deep posterior intracompartmental pressure is a strong predictor of abnormality in the Kite index. The present study showed a probable causal relationship between increased deep posterior intracompartmental pressure and etiopathogenesis of talipes equinovarus.

Clinical abnormalities, intervention program, and school attendance of Down syndrome children in southern Thailand.

BACKGROUND: Down syndrome is the most common chromosomal abnormality with an incidence of 1:700 livebirths. In southern Thailand, most Down syndrome patients are referred to Songklanagarind Hospital for surgical, medical treatment and/or stimulation intervention. OBJECTIVE: To study the clinical features and school attendance of Down syndrome children. MATERIAL AND METHOD: A total of 295 Down syndrome children attended Songklanagarind Hospital. The clinical features of Down syndrome, percentage of children receiving the stimulation intervention program, and attending school were studied. RESULTS: Congenital heart disease was found in 38.6%, gastrointestinal anomalies 16.9%, hematologic malignancy 6.1%, and thyroid disorders 11.4%. The mortality rate of Down syndrome children was 13.2%. Most children (65.6%) received the early stimulation, but only 38.9% attended the speech intervention program within the first 2 years of life. Of the total 109 Down syndrome children aged over 5 years that are still being followed, only 74 (67.9%) attended school. The school attendance was correlated with the family income, but not correlated with the level of maternal or paternal education. CONCLUSION : Congenital heart disease and gastrointestinal anomalies are commonly found in Down syndrome children. Most children received an early intervention program, but only 38.9% received speech intervention. In children aged >5 years, only 68% attended school, and school attendance was correlated with the family income.