Abstract
The term arthrogryposis means contracted and crooked joints. Many different variants of the condition have been described and care must be taken to identify any associated problems so that an appropriate overall assessment of the child can take place. The aim of the Orthopaedic management of these children is to maximise independent living skills and mobility. A key feature is that none of the musculoskeletal tissues around the contracted joint are normal and thus a normal joint with normal function cannot be achieved with any form of treatment either surgical or conservative. Both the parents and clinicians must be aware of this so that realistic treatment goals can be set. A multidisciplinary team is essential in the management of these complex cases.
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References
OMIM. Online Mendelian Inheritance in Man. Johns Hopkins University. http://www.ncbi.nlm.nih.gov/sites/omim
Stern WG. Arthrogryposis multiplex congenita. JAMA. 1923;81:1507.
Hall JG. Arthrogryposis multiplex congenital; etiology, genetics, classification, diagnostic approach and general aspects. J Pediatr Orthop B. 1997;6:159–66.
Hall JG, Reed SD, Driscoll EP. Part 1. Amyoplasia: a common sporadic condition with congenital contractures. Am J Med Genet. 1983;15:571–90.
Bamshad M, Jorde LB, Carey JC. A revised and extended classification of the distal arthrogryposes. Am J Med Genet. 1996;65(4):277–81.
Bamshad M, Van Heest A, Pleasure D. Arthrogryposis: a review and update. J Bone Joint Surg Am. 2009;91 Suppl 4:40–6.
Fahy MJ, Hall JG. A retrospective study of pregnancy complications among 828 cases of arthrogryposis. Genet Couns. 1990;1:3–11.
Sung SS, Brassington AM, Grannat K, Rutherford A, Whitby FG, Krakowiak PA, Jorde LB, Carey JC, Bamshad M. Mutations in genes encoding fast-twitch contractile proteins cause distal arthrogryposis syndromes. Am J Hum Genet. 2003;72:681–90.
Narkis G, Landau D, Manor E, et al. Genetics of arthrogryposis; linkage analysis approach. Clin Orthop. 2007;456:30–5.
Morgan NV, Brueton LA, Cox P, Greally MT, Tolmie J, Pasha S, Aligianis IA, van Bokhoven H, Marton T, Al-Gazali L, Morton JE, Oley C, Johnson CA, Trembath RC, Brunner HG, Maher ER. Mutations in the embryonal subunit of the acetycholine receptor (CHRNG) cause lethal and Escobar variants of multiple pterygium syndrome. Am J Hum Genet. 2006;79:390–5.
Polizzi A, Huson SM, Vincent A. Teratogen update: maternal myasthenia gravis as a cause of congenital arthrogryposis. Teratology. 2000;62:332–41.
Rankin J, Auer-Grumbach M, Bagg W, Colclough K, Nguyen TD, Fenton-May J, Hattersley A, Hudson J, Jardine P, Josifova D, Longman C, McWilliam R, Owen K, Walker M, Wehnert M, Ellard S. Extreme phenotypic diversity and nonpenetrance in families with the LMNA gene mutation R644C. Am J Med Genet A. 2008;146:1530–42.
Fuller DJ. Immobilisation of fetal joints: a cause of progressive prenatal deformity. J Bone Joint Surg Br. 1975;57:115.
Moessinger AC. Fetal akinesia deformation sequence: an animal model. Pediatrics. 1983;72(6):857–63.
Swinyard CA, Bleck EE. The etiology of arthrogryposis. Clin Orthop. 1984;1985:15–29.
Sells JM, Jaffe KM, Hall JG. Amyoplasia, the most common type of arthrogryposis: the potential for good outcome. Pediatrics. 1996;97:225–31.
Staheli LT, Hall JG, Jaffe K, et al. Arthrogryposis: a text atlas. New York: Cambridge Univeristy Press; 1998.
Dillon ER, Bjornson KF, Jaffe KM, Hall JG, Song KJ. Ambulatory activity in youth with arthrogryposis: a cohort study. J Pediatr Orthop. 2009;29:214–7.
Darin N, Kimber E, Kroksmark AK, Tulinius M. Multiple congenital contractures: birth prevalence, etiology and outcome. J Pediatr. 2002;140:61–7.
Fassier A, Wicart P, Dubousset J, Seringe R. Arthrogryposis muliplex congenita. Long-term follow-up from birth until skeletal maturity. J Child Orthop. 2009;3:383–90.
Bevan W, Hall J, Bamshad M, Staheli L, Jaffe K, Song K. Arthrogryposis multiplex congenita (amyoplasia): an orthopaedic perspective. J Pediatr Orthop. 2007;27(5):594–600.
Van Heest A, James MA, Lewica A, Anderson KA. Posterior elbow capsulotomy with triceps lengthening for treatment of elbow extension contracture in children with arthrogryposis. J Bone Joint Surg Am. 2008;90:1517–23.
Van Hest A, Waters PM, Simmons BP. Surgical treatment of arthrogryposis of the elbow. J Hand Surg [Am]. 1998;23:1063–70.
Ezaki M. Treatment of the upper limb in the child with arthrogryposis. Hand Clin. 2000;16:703–11.
Gogola GR, Ezaki M, Oishi SN, Gharbaoui I, Bennet JB. Long head of the triceps muscle transfer for active elbow flexion in arthrogryposis. Tech Hand Up Extrem Surg. 2010;14:121–4.
Mennen U, van Heest A, Ezaki MB, et al. Arthrogryposis multiplex congenita. J Hand Surg [Br]. 2005;30(5):468–74.
Szoke G, Staheli LT, Jaffe K, et al. Medial-approach open reduction of hip dislocation in amyoplasia-type arthrogryposis. J Pediatr Orthop. 1996;16:127–30.
Yau PWP, Chow W, Li YH, et al. Twenty-five year follow-up of hip problems in arthrogryposis multiplex congenital. J Pediatr Orthop. 2002;22:359–63.
Akazawa H, Oda K, Mitani S, et al. Surgical management of hip dislocation in children with arthrogryposis multiplex congenital. J Bone Joint Surg Br. 1998;80(4):636–40.
Murray C, Fixsen JA. Management of knee deformity in classical arthrogryposis multiplex congenital (amyoplasia congenital). J Pediatr Orthop B. 1997;6:186–91.
DelBello DA, Watts HG. Distal femoral extension osteotomy for knee flexion contracture in patients with arthrogryposis. J Pediatr Orthop. 1996;6:192–7.
Brunner R, Hefti F, Tgetgel JD. Arthrogrypotic joint contracture at the knee and foot; correction with a circular frame. J Pediatr Orthop B. 1997;6:192–7.
Klatt JK, Stevens PM. Guided growth for fixed knee flexion deformity. J Pediatr Orthop. 2008;28(6):626–31.
Roy DR, Crawford AH. Percutaneous quadriceps recession: a technique for management of congenital hyperextension deformities of the knee in the neonate. J Pediatr Orthop. 1989;9:717–9.
Niki H, Staheli L, Mosca VS. Management of clubfoot deformity in amyoplasia. J Pediatr Orthop. 1997;17:803–7.
Drummond DS, Cruess RL. The management of the foot and ankle in arthrogryposis congenita. J Bone Joint Surg Br. 1978;60(B):96–9.
Widman RF, Do TT, Burke SW. Radical soft tissue release of the arthrogrypotic clubfoot. J Pediatr Orthop B. 2005;14(2):111–5.
D’Souza H, Aroojis A, Chawara GS. Talectomy in arthrogryposis: analysis of results. J Pediatr Orthop. 1998;18:760–4.
Choi IH, Yang MS, Chung CY, et al. The treatment of recurrent arthrogrypotic clubfoot in children by the Ilizarov method. J Bone Joint Surg Br. 2001;83B:731–7.
Boehm S, Limpaphayom N, Alaee F, Sinclair MF, Dobbs MB. Early results of the Ponseti method for the treatment of clubfoot in distal arthrogryposis. J Bone Joint Surg Am. 2008;90(7):1501–7.
Morcuende JA, Dobbs MB, Frick SL. Results of the Ponseti method in clubfoot associated with arthrogryposis. Iowa Orthop J. 2008;28:22–6.
Van Bosse HJ, Marangoz S, Lehman WB, Sala DA. Correction of arthrogrypotic clubfoot with a modified Ponseti technique. Clin Orthop Relat Res. 2009;467:1283–93.
Aroojis AJ, King MM, Donohoe M, Riddle EC, Kumar SJ. Congenital vertiacla talus in arthrogryposis and other contractural syndromes. Clin Orthop Relat Res. 2005;434:26–32.
Sarwark JF, MacEwen GD, Scott CI. Amyoplasia (a common form of arthrogryposis). J Bone Joint Surg Am. 1990;72:465–9.
Drummond DS, MacKenzie DA. Scoliosis in arthrogryposis multiplex congenita. Spine. 1978;3:146–51.
Daher YH, Lonstein JE, Winter RB, et al. Spinal deformities in patients with arthrogryposis. Spine. 1985;10(7):609–13.
Yingsakmongkol W, Kumar SJ. Scoliosis in arthrogryposis multiplex congenita. J Pediatr Orthop. 2000;20:656–61.
Martin S, Tobias JD. Perioperative care of the child with arthrogryposis. Paediatr Anaesth. 2006;16(1):31–7.
Beals RK. The distal arthrogryposes; a new classification of peripheral contractures. Clin Orthop. 2005;435:203–10.
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Graydon, A.J., Eastwood, D.M. (2014). Orthopaedic Management of Arthrogryposis Multiplex Congenita. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_172
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DOI: https://doi.org/10.1007/978-3-642-34746-7_172
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