Down's syndrome presented with clubfoot deformity: a case report.

A 1 month old girl was referred to the orthopaedic clinic with bilateral clubfoot deformities. At birth, clinical examination showed the typical characters of Down's syndrome and the diagnosis was confirmed by chromosome study. These two conditions appear improbable as their basic pathologies are entirely different. In our patient, the translocation type at the long arm of chromosome 21 was determined in the chromosome study. This result has never been reported in the literature.

Slipped capital femoral epiphysis in Ramathibodi Hospital.

Slipped capital femoral epiphysis is rare in Asiatic Indonesian-Malays. Seven cases (9 hips) of this condition in Ramathibodi Hospital including five boys (average age, 12.5 years) and two girls (average age, 13 years) were reviewed. Most of the cases (4 out of 7) were acute on chronic and mild slips. No endocrine disorder was observed in all cases. All of the patients had a body weight above the mean of the normal population, four of which were obese. For the treatment, a single screw fixation including one case with cancellous and six cases with cannulated type were used. In the follow-up of average 2.5 years, six cases had satisfactory results. Avascular necrosis occurred in one case with mild and chronic slips in which a cancellous screw was used. It is concluded that obesity is the important factor related to the etiology in this study and probably is the same in other developing countries. The effect of a cancellous screw causing avascular necrosis is still questionable.

Chondrodysplasia punctata: a case report.

Chondrodysplasia Punctata is a rare condition in which there are numerous punctate areas of calcification in the epiphysis. The disease involves not only skeletal but also the cardiovascular, cutaneous, ocular and central nervous system. We present a newborn case with clinical as well as radiographic findings similar to Chondrodysplasia Punctata.

Problems in surgical treatment of congenital clubfoot.

Twenty-three patients with 32 congenital rigid clubfeet treated by posteromedial release were reviewed after a follow-up averaging 33 months. The feet were assessed both clinically and radiologically; a satisfactory result was obtained in 17 feet inspite of residual deformity of forefoot adduction. Early operation and adequate postoperative immobilisation were major factors in contributing to a satisfactory result.