PubMed · 13608246
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Coulant, Lopez. [Andrews Bacterides].. https://pubmed.ncbi.nlm.nih.gov/13608246/
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Congenital malformations of the limbs are among the most frequent congenital anomalies found in humans, and they preferentially affect the distal part--the hand or foot. The presence of extra digits, a condition called polydactyly, is the most common limb deformity of the human hand and is the consequence of disturbances in the normal program of limb development. However, despite the extensive use of the developing limb as a classical developmental model, the cellular and genetic mechanisms that control the number and identity of the digits are not completely understood. The aim of this review is to introduce the reader to the current state of knowledge in limb development and to provide the necessary background for an understanding of how deviations from the normal developmental program may lead to polydactyly.
An examination of the feet is an essential component of an evaluation of a newborn. A thorough examination can be performed quickly. Despite its small size, the newborn foot is a complex structure. Most deformities can be diagnosed easily with physical examination alone, using few diagnostic studies. A thorough examination includes assessment of vascular, dermatologic, and neurologic status of the lower extremities, and observation, palpation, and evaluation of joint range of motion in both feet. Common newborn foot abnormalities include metatarsus adductus, clubfoot deformity, calcaneovalgus (flexible flatfoot), congenital vertical talus (rigid flatfoot), and multiple digital deformities-polydactyly, syndactyly, overlapping toes, and amniotic bands. Most treatments include conservative measures, such as observation, stretching, and splinting, which can be performed easily in the family medicine setting. Cases that require surgical correction should be referred to a subspecialist with expertise in correcting lower extremity deformities in children. When surgery is indicated, procedures generally are postponed for six to nine months so that the child will better tolerate anesthesia.
Analysis of footwear characteristics, impressions, and track ways can provide important evidence in a crime scene investigation. In this article, we present examples of how students can be involved in hands-on laboratory-based activities as a means of introducing the forensic sciences. The teaching methodology employs active learning strategies that allow students to discover scientific principles for themselves, develop techniques of critical thinking and problem solving, and gain appreciation for how knowledge arises. By including forensic sciences in the science curriculum, students develop an appreciation for the interrelatedness of all the sciences. From this series of activities, i.e., examining analyses of footprint and footwear impressions, students working as teams will gather information, analyze data, and draw conclusions. Moreover, students will be able to assess the significance of the quality and variability in the data collection process as well as learn the value of controls and experimental design through comparison of results with other groups.