Changes of extracellular matrix of congenital clubfoot

Dongfeng ZHAO; Yang YUE; Bai YANG; Jie GE; Zhihong TANG; Jia SHI

ABSTRACT

BACKGROUND:

Previously, more researches are about the pathological changesinskeleton, nerveandmuscularofcongenitalclubfoot(CCF). Researches are exploring the changes in the surrounding soft tissues of the deformed feet.

OBJECTIVE:

To investigate the relationships between the pathogeny,pathology and pathogenesis of CCF and extracellular matrix (ECM).

DESIGN:

A completely randomized controlled trial.

SETTING:

Institute of Orthopeadics of the Fourth Military Medical University.

PARTICIPANTS:

The study was conducted in the Institute of Orthopeadics of the Fourth Military Medical University from November 1997 to August 2003. The deep fascia of study group was obtained from 15 CCF patients who received operative corrections including 11 males and 4 females with an average of 9 months. Five infant corpses who died from non-neural muscular diseases and non-collagen diseases aged between 4 and 21 months with an average age of 11 months were selected in the control group.

METHODS:

Immunohistochemical investigation was used for the assay of both study and control group. Slices were quantitatively analyzed by Letica Q,570c color image analysis and management system.MAIN OUTCOME

MEASURES:

Positive expressions of collagen Ⅰ, Ⅱ and Ⅲ, and the relative contents in the deep fascia of both groups.

RESULTS:

The grey values for relative contents of collagen Ⅰ, Ⅱ and Ⅲ in the interior foot were 116. 43 ± 11. 80, 132. 91 ± 8. 88, and 184. 40 ± 11.82respectively in the study group, and 169.28 ± 8.17, 176. 33 ± 9.47, and 194. 38 ±5.87 in the control group. The contents of collagen Ⅰ, Ⅱ and Ⅲincreased in the contractured tissues of CCF group with the most significant increase in collagen Ⅰ, followed by collagen Ⅲ and the increase of collagen Ⅱwas least. Additionally, collagen Ⅰ was negatively correlated with collagen Ⅲ. The positive expression of collagen Ⅱ might be an accompanying phenomenon, which had no correlation with collagen Ⅰ and Ⅲ.

CONCLUSION:

ECM changes in CCF are accorded with fibrosis in tissues and organs and general fibroelastosis. Therefore, CCF might be caused by the fibrosis of interior foot.