Normal collagen structure in the posterior ankle capsule in different types of clubfeet

In 21 clubfeet (17 children) of different types (idiopathic, spina bifida, syndromal), the authors analyzed modifications and crosslinks in collagen a nd their possible relations with clinical stiffness of clubfoot deformity, as measured by the Dimeglio/Bensahel method. In a biopsy of the capsule of the ankle joint, the number of hydroxylysine residues (mean +/-standard dev iation; 27.1 +/- 3.4) and the number of pyridinium crosslinks per collagen molecule (0.41 +/- 0.12) were normal. This indicates normal processing of c ollagen molecules and normal alignment of collagen molecules within fibrils despite the variety of clubfeet, and even in scar tissue.