The Journal of Bone and Joint Surgery (American). 2006;88:496-502.
doi:10.2106/JBJS.E.00093
© 2006 The Journal of Bone and Joint Surgery, Inc.
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Lack of Seasonal Variation in Idiopathic Talipes Equinovarus

Randall T. Loder, MD1, David M. Drvaric, MD2, Brian Carney, MD3, Zachary Hamby, MD4, Simon Barker, MD5, David Chesney, MD6 and Nicola Maffulli, MD7

1 James Whitcomb Riley Hospital for Children, Room 4250, 702 Barnhill Drive, Indianapolis, IN 46202. E-mail address: rloder{at}iupui.edu
2 Shriners Hospital for Children, 516 Carew Street, Springfield, MA 01104
3 Dartmouth-Hitchcock Medical Center, Pediatric Orthopaedics, One Medical Center Drive, Lebanon, NH 03756
4 Atlanta Medical Center, 303 Parkway Drive, NE, Box 423, Atlanta, GA 30312
5 University of Aberdeen Medical School, Aberdeen AB25 2ZD, Scotland
6 Department of Trauma and Orthopaedic Surgery, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, England
7 Keele University School of Medicine, Thornburrow Drive, Hartshill, Stoke on Trent, Staffordshire, ST4 6QG, England

Investigation performed at James Whitcomb Riley Hospital for Children, Indianapolis, Indiana

In support of their research for or preparation of this manuscript, one or more of the authors received grants or outside funding from the Garceau Professorship Endowment, the Rapp Pediatric Orthopaedic Research Endowment, SPARKS (Sport Aiding Medical Research for Kids), and Grampian Health Authority Research Endowment Fund. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: One proposed etiology of idiopathic talipes equinovarus is an in utero enterovirus infection. Enterovirus infections demonstrate seasonal variation in temperate climates.

Methods: We collected data on 1202 children with idiopathic talipes equinovarus born in the Northeastern United States, Midwestern United States, and the United Kingdom to investigate a seasonal variation in this congenital deformity. Birth date, gestational age at the time of delivery, gender, race, and laterality were tabulated and subjected to univariate and bivariate analyses.

Results: There were 774 boys and 428 girls with idiopathic talipes equinovarus. The birth location was the United Kingdom (458 children), the Midwestern United States (426 children), and the Northeastern United States (318 children). No significant differences were detected among the geographic groups with respect to gender, race, or laterality, and no variation in month of birth or month of conception was noted.

Conclusions: This study does not support an in utero enterovirus infection as an etiology of idiopathic talipes equinovarus in industrialized populations.


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