Pediatric Joint Contractures

Joint contractures in the lower extremities are found in a variety of congenital, developmental and acquired conditions. History and meticulous physical examination are required to create an appropriate treatment algorithm for your patient. Non-operative modalities should be attempted prior to surgical treatment after ensuring that the adjacent joints are reduced and not dislocated. Soft tissue lengthening or releases and bone shortening are the foundation of surgical treatment, and care of the neurovascular bundle should always be at the forefront of the surgeon’s mind. Postoperative management should be focused on regaining joint mobility and postoperative immobilization should only be considered in rare circumstances when a dislocated joint has been reduced.