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Centre de recherche

Advancing Personalized Medicine for Limb Deformities Through Translational Research

Scientific Conference of the Institut TransMedTech

Monday 15 January 2018 from 15:00 at 16:00

Speaker

  • Matthew B. Dobbs, MD, FAOA
    • Professor and Director of Strategic Planning
      Department of Orthopaedic Surgery
      Washington University School of Medicine
      Senior Editor, Clinical Orthopaedics and Related Research
      Vice-President, United States Bone and Joint Initiative
      Secretary, Association of Bone and Joint Surgeons
      Vice Chair, Grants, Orthopaedic Research and Education Foundation


BACKGROUND

Clubfoot is one of the most common pediatric orthopaedic disorders. While the Ponseti method has revolutionized clubfoot treatment, it is not effective for all patients. When the Ponseti method does not correct the foot, patients are at risk for lifelong disability and may require more-extensive surgery.

METHODS

Human gene sequencing, molecular genetic engineering of mouse models of clubfoot, MRI of clubfoot, and development of new treatment methods all have been used by our group to understand the biological basis and improve therapy for this group of disorders.

RESULTS

We gained new insight into clubfoot pathogenesis from our discovery that mutations in the PITX1-TBX4-HOXC transcriptional pathway cause familial clubfoot and vertical talus in a small number of families, with the unique lower limb expression of these genes providing an explanation for the lack of upper extremity involvement in these disorders. MRI studies revealed corresponding morphologic abnormalities, including hypomorphic muscle, bone, and vasculature, that are not only associated with these gene mutations, but also are biomarkers for treatment-resistant clubfoot.

CONCLUSIONS

Based on an understanding of the underlying biology, we improved treatment methods for neglected and syndromic clubfoot, developed new treatment for congenital vertical talus based on the principles of the Ponseti method, and designed a new dynamic clubfoot brace to improve strength and compliance.

 
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Updated on 1/11/2018
Created on 1/11/2018
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