Hand Assessment and Management of Arthrogryposis Multiplex Congenita

Qualidade de vida de pacientes com artrogripose múltipla congênita após cirurgia e/ou reabilitação

“…Bennett et al (1985) reported poor results with skin and adductor release only and recommend MCP joint fusion. Bayne (1985) employs metacarpal osteotomy along with soft tissue release. If possible, we believe that the best addition to release procedures is the addition of an active thumb extensor, if absent, to balance the first ray.…”

“…The interphalangeal joint flexion contractures found in arthrogryposis are particularly difficult to treat. Reviews of this problem have suggested that soft tissue releases of the PIP joints do not give lasting correction and that fusion may be indicated in severe cases (Bayne, 1985;Bennett et al, 1985;Lloyd-Roberts and Lettin, 1970). The interdigital webbing seen at the base of the fingers, however, can be released and allow the patient increased function, especially when using an interlacing grip.…”

A revolutionary use of wrist arthroscopy in paediatric arthrogryposis? a case report and review of the literature

“…1,5 More recently, involvement of the triangular fibro-cartilage complex (TFCC) has also been noted in these patients. 5 Figure 1 Left wrist radio-carpal arthroscopy (lunate on top, radius at the bottom) demonstrating the "snowstorm" of thick fibrous plica bands assessed with a probe (seen in the centre).…”

“…2 Arthrogryposis manifests in a highly variable manner, with a classic presentation of the upper limb being that of a wasted shoulder, rigid elbow, flexed and ulnar deviated wrist and fingers with a thumb-in-palm deformity. [3][4][5][6][7] Arthrogryposis of the wrist is complex and is often associated with dysplasia at the radiocarpal joint, further limiting movement in the wrist.4 Management of this involves addressing abnormalities of the joint and surrounding critical structures including abnormal insertions of muscles, tendons, ligaments and joint capsules. 1,5 More recently, involvement of the triangular fibro-cartilage complex (TFCC) has also been noted in these patients.…”

“…[3][4][5][6][7] Arthrogryposis of the wrist is complex and is often associated with dysplasia at the radiocarpal joint, further limiting movement in the wrist.4 Management of this involves addressing abnormalities of the joint and surrounding critical structures including abnormal insertions of muscles, tendons, ligaments and joint capsules. 1,5 More recently, involvement of the triangular fibro-cartilage complex (TFCC) has also been noted in these patients. 5 Figure 1 Left wrist radio-carpal arthroscopy (lunate on top, radius at the bottom) demonstrating the "snowstorm" of thick fibrous plica bands assessed with a probe (seen in the centre).…”