Clinic, diagnosis and treatment of congenital arthrogryposis in children

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Abstract

Experience in treatment of limb contractures and deformities in children with congenital arthrogryposis is presented. The main principles of treatment were detected. Complex of diagnostic and curative measures including conservative treatment of patients stating from birth is described in details. Conservative treatment consists of therapeutic exercises, massage, physiotherapy, special braces and plaster bandages. Surgical treatment method using external fixation devices is presented. The method of biocontrol disturbance detection is given and the use of functional biocontrol (FBC) method for the treatment of this pathology is well grounded. Early results of FBC use are evaluated as positive ones that confirms the expedience of further use of FBC for the treatment of patients with congenital arthrogryposis.

About the authors

O. L. Malakhov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

I. S. Kosov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

I. A. But-Gusaim

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

S. A. Mikhaylova

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

References

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Supplementary files

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2. Fig. 1. Appearance of a patient with contractures of the upper limbs.

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3. Fig. 2. Characteristic posture of the patient when trying to abduct the shoulders.

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4. Fig. 3. View of the patient with contractures of the lower extremities.

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5. Fig. 4. View of a patient with an asymmetric lesion of the lower extremities.

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6. Fig. 5. Arbitrary bioelectrical activity of the deltoid and trapezius muscles of patient L. during normal walking (a) and when simulating arm swings in time with walking (b). I — left deltoid, II — left trapezius, III — right deltoid, IV — right trapezius muscle, V — goniogram of the right knee joint.

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7. Fig. 6. Voluntary bioelectrical activity of the flexor muscles (1) and extensor muscles (II) of the foot and the goniogram of the ankle joint (III) of patient L. in walking: a — left, b — right leg: c — goniograms of the ankle joints in the step cycle.

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8. Fig. 7. Stages of applying a plaster cast.

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9. Fig. 8. Arbitrary bioelectrical activity of the deltoid (I) and biceps (II) muscles of the right hand of patient O. before (a) and after (b) treatment by functional biofeedback.

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10. Fig. 9. Voluntary bioelectrical activity of the left deltoid muscle of patient B. before (a) and after (b) treatment by functional biofeedback; formation of the motor skill of shoulder abduction (c).

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11. Fig. 10. Correction of hand deformity in the Ilizarov apparatus.

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12. Fig. 11. Patient P., 9 years old. Diagnosis: arthrogryposis, contractures of the joints of the lower extremities. a - the first stage of treatment - correction of contractures of the knee joints in the apparatus of Volkov-Oganesyan; b — after the first stage of treatment: flexion contractures of the hip joints; c — appearance, d — radiograph after the second stage of treatment.

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13. Fig. 12. Patient B. Diagnosis: arthrogryposis, bilateral foot deformity. a - upon admission; b — at the stage of treatment.

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14. Fig. 13. Treatment of arthrogrypotic clubfoot using the Ilizarov apparatus: a — before treatment, b — during treatment.

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