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Arthrogryposis: Upper extremity reconstruction for arthrogryposis

The Pediatric Upper Extremity, Page: 803-837
2015
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Book Chapter Description

The care of the child with arthrogryposis requires a global understanding of that child’s needs and abilities. The results of any intervention at one joint in the arm can be influenced not only by the condition of other joints in that limb, but in the lower extremities as well. Treatment options at the shoulder are limited, with a humeral rotational osteotomy performed most commonly to address an internal rotation contracture. The elbow is most often positioned in extension, often requiring a posterior capsular release with triceps lengthening and ulnar nerve transposition to gain passive motion. Active elbow flexion is more difficult to achieve. At the wrist, the carpal wedge osteotomy has recently been shown to have reliably good results in correcting wrist flexion contractures (J Bone Joint Surg Am. 2013;95(20):e150; J Hand Surg Am. 2013;38(2):265–70). Correction of thumb deformities can reliably improve pinch and grasp, while correction of camptodactyly remains unpredictable.

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