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Multi-ligament Laxity

  • Kevin J. LittleEmail author
Reference work entry

Abstract

Increased mobility of multiple joints is characterized as a hypermobility syndrome or generalized joint laxity. Joint hypermobility lies on a spectrum of disease from milder forms such as benign joint hypermobility syndrome or generalized joint laxity to more severe forms including Ehlers-Danlos syndrome and Marfan syndrome. While this increased joint mobility is not indicative of a pathologic state in the joint, it does confer an increased risk of injury or arthritis. In the upper extremity, joint laxity can increase the rate of shoulder multidirectional instability, increase the risk of supracondylar humerus fractures, and lead to early onset arthritis in the thumb carpometacarpal joint. Following injury, patients with hypermobility may require more extensive therapy and a longer duration of treatment to return to baseline function. Physiotherapy is the mainstay of treatment for joint hypermobility. This allows for increased dynamic stability for joints where ligamentous laxity does not impart adequate stability. Surgical treatment is recommended only after patients fail 3–6 months of extended physiotherapy or in cases where the injury sustained in addition to the baseline hyperlaxity has a better prognosis with surgical treatment than without, such as with a bony Bankart lesion in the shoulder. Prompt recognition of the hypermobility syndrome is critical towards patient education, beginning appropriate therapy, and returning the patient to baseline function.

Keywords

Rotator Cuff Marfan Syndrome Joint Laxity Joint Hypermobility Ligamentous Laxity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.University of Cincinnati Department of Orthopaedic Surgery; Hand and Upper Extremity SurgeryCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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