This is a concept of multiple congenital contractures, based upon clinical experience with the malformation and available literature, leading to a conception of the multiple categories of etiology, which cause neuropathic or myopathic muscle weakness or limb immobilization. The muscle weakness and imbalance of muscle power around the joints elicits a physiological compensatory collagenic response, which replaces atrophied muscle fibers with connective tissue and thickens the joint capsule sufficiently to result in prenatal fixation of limb segments at the joint.
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Chester A. Swinyard (1982) studied this question.
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