By Lynn T. Staheli, Judith G. Hall, Kenneth M. Jaffe, Diane O. Paholke
The time period arthrogryposis describes quite a number congenital contractures that bring about youth deformities. It features a variety of syndromes and sporadic deformities which are infrequent separately yet jointly are usually not unusual. the purpose of this e-book is to supply health and wellbeing care pros, participants affected with arthrogryposis, and their households with a worthy consultant to higher comprehend the and its treatment. With this aim in brain, the editors have taken nice care to make sure that the presentation of advanced medical info is right away scientifically actual, sufferer orientated, and obtainable to readers with out a scientific heritage.
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Additional resources for Arthrogryposis: a text atlas
For example, fine motor function is the major objective of upper extremity management. In contrast, in the lower limbs, our primary objectives are symmetry and stability. Although our primary focus is on amyoplasia, these basic principles usually apply to all forms of congenital contractures. Other types of arthrogryposis that commonly require orthopedic treatment are briefly covered at the end of this chapter. The primary objective of orthopedic management is to improve function by correcting deformity.
The contractures tend to improve with growth and nonoperative management. Scoliosis may require surgery. Knee flexion contractures may be most disabling and may require operative correction (Langenskiöld, 1985). These varied forms of arthrogryposis are usually readily differentiated if a careful evaluation is made. The management principles are, however, very similar to those for amyoplasia. In Chapter 3, we deal with management of lower extremity deformity. 44 Upper Limb and Spine 45 Chapter Three Spine Upper Limb Chapter Contents Introduction Patterns of Involvement Shoulder Elbow Wrist Hand Treatment Shoulder Elbow Wrist Hand Results of Surgical Treatment Summary Page 45 45 45 46 46 46 47 47 47 48 49 50 50 A.
The distal interphalangeal (DIP) joints are usually stiff in extension. If this hand has a mobile thumb, this deformity at least allows prehension, if not grasp. Treatment Fig. 4 Adaptive movement. This child has adapted well in function. With voluntary control and good sensation, hand function is remarkably good even without surgical intervention. There are three general treatment goals for the arthrogrypotic upper extremity: gaining and maintaining a functional range of motion of the upper extremity joints, first passively and then actively, if possible; increasing functional abilities, particularly the activities of daily living of eating, dressing, and toileting with occupational therapy, adaptive devices, and surgery; and maximizing educational and vocational potential, which often involves using computer keyboards.