Background: Arthrogryposis Multiplex congenita is a
rare disorder, characterized by multiple joint deformities
i.e. multiple congenital contractures, with shapelessly
cylindrical limbs and absent skin creases.
Club foot can be the only obvious deformity of this
widespread disorder.
Objective: To assess the most frequent recurrent
deformity after extensive soft-tissue release operations for
arthrogrypotic club foot and its appropriate treatment
regarding combined tendon transfer and bony operations.
Methods: A retrospective study of 14 patients with
arthrogrypotic club foot (28 feet), had been operated on by
multiple soft tissue and bony operations and followed in a
period between January (1993) till February (1999).
Both clinical assessment including goniometer use to
measure the recurrent deformity, and radiological
assessment, was used in this study.
Results: In this series, 4 patients (7 feet) had recurrent
deformity, 3 patients
(5 feet) out of these 4 had recurrent forefoot adduction, 2
of them had bilateral affection. The 4th patient had
bilateral recurrent varus heel.
Conclusion: The main problem in arthrogrypotic club
foot is the liability for recurrence. The most frequent
recurrent deformity was forefoot adduction. Combined
tendon transfer and bony operations can correct the
deformity once performed at the same cession forefoot
adduction. All required 2nd operation, in the 1st 3 patient
combined Evan’s (calcaneocuboid wedge-excision) and
tibialis anterior transfer operations were performed.
Talectomy was performed on one foot in the 4th patient,
combined with capsulectomy of the calcaneocuboid joint,
while triple arthrodesis don on the other foot
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Thermal performance of closed wet cooling tower has been investigated experimentally and theoretically
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