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Journal of Bone and Joint Surgery, 1968;50:89-112.
© 1968 by The Journal of Bone and Joint Surgery, Inc

Arthrogryposis Multiplex Congenita

A REVIEW OF FORTY-FIVE CASES

HARVEY LEE FRIEDLANDER M.D.1, G. WILBUR WESTIN M.D.1, and WALTER L. WOOD JR. M.D.1

1 From the Los Angeles Unit of Shriners' Hospitals for Crippled Children, Los Angeles

Forty-five patients with arthrogryposis multiplex congenita treated at the Los Angeles Unit of the Shriners' Hospitals for Crippled Children between 1952 and 1964 were reviewed. The prenatal course, birth history, and family history of most of the patients were also investigated. The results of various surgical procedures used to treat these patients were analyzed. The patients were classified according to pretreatment involvement of both the upper extremities and lower extremities, and also according to total involvement. The interim or end results were rated in a similar manner. Thirty-three of the patients who were followed two years or more were evaluated. The average length of follow-up in this group was 7.4 years.

Two conclusions were made on the basis of this detailed study of forty-five patients with arthrogryposis multiplex congenita:

1. There is a very high incidence of recurrence of deformity, especially at the ankle and foot, following correction by casts, braces, surgery, or combinations of the three. Many times the surgery must be repeated. Treatment must be constant, prolonged, and radical. After the deformities are corrected, the position must be maintained with braces, casts, or bivalved casts until the end of the growth period in order to minimize recurrence.

2. With prolonged treatment using casts, splints, braces, and multiple radical soft-tissue and bone operations, deformities can be corrected, and fair to good results can be achieved in many cases.


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