We treated a patient with multiple congenital joint dislocations and facial dysmorphisms consistent with Larsen syndrome.
Sequencing of the FLNB gene resulted in identification of a novel, de novo 508G>C point mutation resulting in substitution
of proline for a highly conserved alanine (A170P). This mutation has not been described previously but is likely causative
because this alanine is highly conserved and is located in the calponin homology domain where other mutations have been described.
We also report the successful use of a minimally invasive technique in achieving initial correction of bilateral congenital
knee dislocations in this patient. The technique consists of serial manipulations and castings followed by an open quadriceps
tenotomy. Longer followup is needed to ensure maintenance of correction and to avoid the need for more extensive surgery,
which has been the traditional treatment for congenital knee dislocation associated with Larsen syndrome.
One or more of the authors (MBD) have received funding from the Shriners Hospital for Children and St Louis Children’s Hospital
Foundation; and NIH NINDS K12 (NS01690) (CAG).
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent was obtained.