By David L. Rimoin (auth.), Harry Harris, Kurt Hirschhorn (eds.)
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The author would suggest that the numerical subdivision of these disorders into types I, II, and III be discontinued, as types I and III have been used interchangeably for the two different lethal disorders in the past. ,343a and Yang et al. 347a The four siblings described by Houston et al. 116 were all born prematurely and were either stillborn or died within 30 min. Birth length ranged between 25 and 29 cm and birth weight between 900 and 1800 g. In contrast to Langer-Saldino type achondrogenesis, the head does not appear significantly large compared to the trunk; the skull may be extremely soft, appearing to consist of small plaques of bone in a membranous calvarium.
Rimoin The vertebral columns show total lack of ossification of the cervical, thoracic, vertebral lumbar, and sacral bodies, yet ossification centers representing the pedicles and neural arches are present on either side down to midsacrum. The ribs are well ossified throughout their length but are short and relatively narrow, with marked expansion at the costochondral junctions. There may be evidence of intrauterine rib fractures with rather abundant callus formation. No ossification centers for the sternum are evident.
This limitation of finger flexion is presumably present in early fetal life, since many of the finger and palmar flexion creases are absent. The feet are short and broad with severe club foot deformity-metatarsus varus and equinus. The club feet are resistant to therapy and should be handled aggressively. The halluces are broad, frequently deviated, and widely separated from the second toe. Progressive scoliosis may develop during the first year of life. The scoliosis usually becomes quite severe with weight bearing, and at adolescence is often associated with kyphosis, which may result in respiratory difficulty in adulthood.
Advances in Human Genetics by David L. Rimoin (auth.), Harry Harris, Kurt Hirschhorn (eds.)