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Published on: November 9, 2018
Treatment of the Lower Extremity Contracture/Deformities
Harold J P van Bosse1, Eva Pontén, Akifusa Wada
1*Shriners Hospitals for Children, Philadelphia, PA †Department of Pediatric Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden ‡Department of Orthopaedic Surgery, Saga Handicapped Children's Hospital, Saga, Japan §Arthrogryposis Clinic, Turner Scientific and Research Institute for Children's Orthopedics, Saint Petersburg, Russia ††Turner Scientific and Research Institute for Children's Orthopedics §§Department of Foot and Ankle Surgery, Neuroorthopaedics and Systemic Disorders, Turner Scientific and Research Institute for Children's Orthopedics, Saint Petersburg **Yaroslavl Regional Children's Hospital, Yaroslavl, Russia ∥Department of Pediatric Orthopedics and Trauma Surgery, University Children's Hospital of Krakow, Krakow, Poland ¶ALYN Rehabilitation Hospital for Children and Adolescents, and Pediatric Orthopedic Service, Shaare-Zedek Medical Center #Faculty of Medicine, Selcuk University, Konya, and Faculty of Medicine, Erzincan University, Erzincan, Turkey ∥∥Department of Orthopedics and Traumatology, Medical School of Selcuk University ¶¶Konya Bozkir State Hospital ##Department of Orthopedics and Traumatology, Meram University Hospital and Selçuk University Faculty of Medicine, Konya, Turkey.
Arthrogryposis multiplex congenita (AMC) involves diverse lower limb deformities. While hip and knee treatments are increasingly surgical, foot deformity management has shifted towards less invasive approaches to maximize patient independence.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Congenital deformities
Background:
- Arthrogryposis multiplex congenita (AMC) presents a broad range of lower extremity deformities.
- Treatment aims to enhance patient independence and functional potential.
- Varied approaches exist for hip, knee, and foot deformities in AMC.
Purpose of the Study:
- To summarize current treatment strategies for lower extremity deformities in arthrogryposis multiplex congenita.
- To highlight evolving treatment paradigms discussed at an international symposium.
Main Methods:
- Synopsis of treatment strategies presented at the Second International Symposium on Arthrogryposis.
- Review of approaches for hip, knee, and foot deformities in AMC patients.
Main Results:
- Interventional approaches are increasingly utilized for hip and knee contractures and dislocations in AMC.
- A paradoxical trend shows a decrease in surgical interventions for foot deformities in AMC.
- Treatment goals are tailored to patient potential, from basic function to active ambulation.
Conclusions:
- Management of AMC lower extremity deformities requires tailored, individualized strategies.
- The shift in foot deformity treatment suggests a move towards conservative or less invasive methods.
- Continued international collaboration and discussion are vital for advancing AMC treatment.
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