Orthopaedic manifestations of Bardet-Biedl syndrome.

Bardet-Biedl syndrome is an autosomal recessive disorder poorly characterized in the orthopaedic literature. Classic manifestations of the syndrome include pigmentary retinopathy, obesity, polydactyly, hypogonadism, and mild mental retardation. Previous reports have implied that orthopaedic findings are due to an epiphyseal dysgenesis inherent to the syndrome. The purpose of this study was to evaluate the orthopaedic manifestations of 27 patients with this syndrome. Detailed medical histories and physical examinations as well as pedigree analyses and radiographic bone surveys were performed. Orthopaedic findings included the following: 17 patients had postaxial polydactyly, 4 patients had scoliosis, 2 patients had tibia valga, 2 patients had tibia vara, and 1 patient had Legg-Calve-Perthes. The bone survey did not reveal any additional radiographic abnormalities. Based on these results, Bardet-Biedl syndrome patients do not have epiphyseal dysgenesis; their epiphyseal manifestations are probably the result of their obesity.