Mono-allelic mutations in PITX1 are associated with congenital clubfoot, with or without deficiency of long bones and/or mirror-image polydactyly in addition to Liebenberg syndrome, defined by the presence of carpal synostosis, dysplastic elbow joints, and brachydactyly [49]. This evidence concerns the gene PITX1 and Brachydactyly - elbow wrist dysplasia.