Arthrogryposis multiplex congenita. Long-term follow-up from birth until skeletal maturity
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- Fassier, A., Wicart, P., Dubousset, J. et al. J Child Orthop (2009) 3: 383. doi:10.1007/s11832-009-0187-4
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The aim of this retrospective long-term study was to review and present the effects of treatment for 11 children with arthrogryposis multiplex congenital, or amyoplasia, followed from birth until skeletal maturity.
We evaluated walking ability, age of beginning to walk, required ambulatory devices, age of independent walking and muscle strength.
Our series showed babies with severe limb involvements without spine abnormalities. Despite the initial severity of involvement, nine patients finally became ambulators with flexion contracture of less than 20° on hips and 15° on knees, and six were independent walkers before the age of 2.5 years. The two non-ambulators presented severe scoliosis at skeletal maturity, which needed spinal fusion.
We conclude that long-term ambulatory status at skeletal maturity is not correlated with the severity of condition at birth. A prognosis for ambulation at skeletal maturity will be done before 2.5 years of age. We believe that early aggressive management of children with severe arthrogryposis is warranted and justified.