Fukuhara K, Schollmeier G, Uhthoff H K
University of Ottawa, Canada.
J Bone Joint Surg Br. 1994 May;76(3):450-7.
We studied 16 club feet and 27 normal feet from spontaneously aborted human fetuses in the second trimester of gestation and measured the length of the spring ligament, and the declination angle and size of the talus. We also studied the cellular characteristics of the spring ligament and the immunohistochemical features of the medial ankle ligaments using monoclonal antibodies against type-III collagen, desmin, vimentin, and smooth muscle actin. Histomorphometric results indicated that the talar deformity was not the primary lesion. Histological and immunohistochemical findings showed that the cells and collagen fibres of the medial ankle ligaments of club feet appeared to be the site of the earliest changes, in that they had lost their spatial orientation and had contracted. In severe club feet before the third trimester of gestation, myofibroblast-like cells seemed to create a disorder of the ligaments resembling fibromatosis. This led to contraction and resulted in typical club-foot deformity.
我们研究了来自妊娠中期自然流产的人类胎儿的16只畸形足和27只正常足，测量了跟舟韧带的长度、距骨的偏斜角度和大小。我们还使用抗III型胶原、结蛋白、波形蛋白和平滑肌肌动蛋白的单克隆抗体，研究了跟舟韧带的细胞特征和内侧踝关节韧带的免疫组织化学特征。组织形态计量学结果表明距骨畸形不是原发性病变。组织学和免疫组织化学结果显示，畸形足内侧踝关节韧带的细胞和胶原纤维似乎是最早发生变化的部位，因为它们失去了空间方向并发生了收缩。在妊娠晚期之前的严重畸形足中，肌成纤维细胞样细胞似乎导致了类似纤维瘤病的韧带紊乱。这导致收缩并导致典型的畸形足畸形。
