Serial Operational Treatment of Arthrogryposis With Complete Dislocation of Hips and Knees

Abstract

Introduction: Arthrogryposis multiplex congenita (AMC) with incidence of 1 in 3000 of births is characterized by multiple rigid joint and soft-tissue contractures. Case Presentation: We present a case of AMC with severe soft tissue and joints contractures, especially joints of lower limb and elbows, bilateral complete dislocation of hips (CDH) and knees (CDK) (type III), bilateral elbow joint dislocations and severe bilateral clubfeet, who had had some successful operations during five years on lower extremities. Discussion: The main goal of our treatment was achieving the maximal function of lower limbs. Passive stretching range of motion on stiff joints especially of lower limbs must be started as soon as possible; serial castings, open reduction of CDH followed by derotational femoral osteotomy and shortening was helpful. Surgery performed at earlier age gives the best functional outcome.