13 March 2026 : Review article
Management of Lower-Extremity Deformity in Arthrogryposis Multiplex Congentia: A Narrative Review
Yongwei Shang DEF 1, Jianjie Xu ABC 1*DOI: 10.12659/MSM.951581
Med Sci Monit 2026; 32:e951581
Table 1 Management principles for lower-extremity deformities in AMC.
| Region | Deformity | Treatment goal | Management strategy |
|---|---|---|---|
| Hip | Contractures (flexion, abduction) | Preserve functional ambulation; Maintain flexion contractures below 30° | Mild/moderate: Percutaneous anterior release + casting. Multiplanar deformities: Proximal femoral reorientational osteotomy |
| Dislocations | Achieve hip stability; comfortable sitting posture | Unilateral: Early open reduction (ideally <12 months) + spica castingBilateral: Manage non-operatively if symmetric/stable; reduction considered only for selected ambulatory patients (high complication risk >70%) | |
| Knee | Flexion or extension contractures (mild <30° to devere >60°) | Achieve and maintain sufficient Range of Motion (ROM) for functional sitting and standing. | Mild/moderate: Serial casting, growth guidance (eg, anterior 8-plating), soft tissue releasesSevere (>60°): Gradual correction via external fixation (Ilizarov) + soft tissue releaseMature: Distal femoral extension osteotomy or quadricepsplasty |
| Foot | Rigid clubfoot | Achieve a pain-free, stable, plantigrade foot | First-Line: Ponseti method (requires more casts/bracing than idiopathic)Recurrence: Limited soft-tissue release, osteotomies. Severe/Complex: External fixation (Ilizarov), talectomy, or triple arthrodesis (adolescents) |
| Congenital vertical talus | Approach: Dobbs method casting + limited open reduction/pinning with high recurrence rate (45% in AMC) |