Original articleThe spectrum of foot deformities in Loeys-Dietz syndromeBadin, Daniela; Dietz, Harry C. IIIb; Sponseller, Paul D.a Author Information aDepartment of Orthopaedic Surgery bDepartments of Genetic Medicine and Pediatrics, The Johns Hopkins University, Baltimore, Maryland, USA Received 4 April 2022 Accepted 29 August 2022 Correspondence to Paul D. Sponseller, MD, MBA, Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, JHOC 5223, Baltimore, MD 21287, USA, Tel: +1 410 502 2160; fax: +1 443 287 6015; e-mail: [email protected] Journal of Pediatric Orthopaedics B: November 14, 2022 - Volume - Issue - 10.1097/BPB.0000000000001018 doi: 10.1097/BPB.0000000000001018 Buy PAP Metrics Abstract Loeys-Dietz syndrome (LDS) is characterized by a wide spectrum of musculoskeletal manifestations, including foot deformities. The spectrum of foot deformities in LDS has not been previously characterized. Our objective was to describe the incidence and characteristics of foot deformities in LDS. We retrospectively reviewed the demographic, clinical and imaging data for patients diagnosed with LDS who were seen at our Orthopedic surgery department from 2008 to 2021. We performed descriptive analyses and compared distributions of deformities by LDS genetic mutations. Of the 120 patients studied, most presented for evaluation of foot deformities (N = 56, 47%) and scoliosis (N = 45; 38%). Ninety-seven patients (81%) had at least one foot deformity, and 87% of these patients had bilateral foot deformities. The most common deformities were pes planovalgus (53%) and talipes equinovarus (34%). Of patients with foot deformities, 58% presented for evaluation of the feet. Of patients with pes planovalgus, only 17% presented for evaluation of the feet. Among patients with pes planovalgus, 2% underwent surgery and 16% used orthotics compared with 76% and 42%, respectively, for patients with talipes equinovarus. We found no association between deformities and genetic mutations. Bilateral foot deformities are highly prevalent in patients with LDS and are the most common reason for presentation to orthopedic surgeons. Although pes planovalgus is the most common deformity, it rarely prompted surgical treatment. Orthopedic surgeons treating LDS patients should be aware of the unique characteristics of foot deformities in LDS. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.