Aims: The aim of the study is to compare protein, cellular, morphological and biomechanical characteristics of tissues obtained from medial (contracted) and lateral (uncontracted) part of the foot with a congenital deformity pes equinovarus (clubfoot).

Idiopathic pes equinovarus (clubfoot) is a congenital deformity of the foot and lower leg.

Although it is the most common birth defects affecting the musculoskeletal system, its etiopathogenesis is not clear. It is supposed, that clubfoot belongs to a group of fibroproliferative disorders whose origin and multi-hierarchical effect remain unknown. In this study, a correlative approach is applied to analyse each of the hierarchical levels: from proteins to the ECM architecture. First, the tissue samples are collected from the contracted medial side and the lateral (control) side of clubfoot. Second, the samples are characterized for protein composition, and the isolated cells and tissue samples are studied for morphology by means of optical microscopy and uniaxial tensile test. The results are statistically related in a morphological and functional map. Finally, the results are compared with the physiological parameters of connective tissue and the differences can be employed for enzymatic treatment of fibrotic tissue and consequent improvement of conservative therapy of the clubfoot.