Microstructural Analysis of Collagenous Structures in Relapsed Clubfoot Tissue

Talipes equinovarus congenitus (clubfoot) is frequently defined as a stiff, contracted deformity, but few studies have described the tissue from the point of view of the extracellular matrix, and none have quantified its mechanical properties. Several researchers have observed that clubfoot exhibits signs of fibrosis in the medial side of the deformity that are absent in the lateral side. Our study aims to quantify the differences between the medial and lateral side tissue obtained from relapsed clubfoot during surgery in terms of the morphological and mechanical properties of the tissue. Combining methods of optical and atomic force microscopy, our study revealed that the medial side has a higher Young’s modulus, contains more collagen and less adipose tissue and that the collagen fibers propagate at a higher frequency of the crimp pattern after surgical dissection of the tissue. Our study offers a multi-correlative approach that thoroughly investigates the relapsed clubfoot tissue.