Correction of Severe Contractures, Pterygium and Lower Limb Deformities Caused By Arthrogryposis

Arthrogryposis is a disease that has variable associated joint contractures and muscular weaknesses. Treatment of this disorder is often determined by the underlying strength of the various muscle groups. A 14 year old male diagnosed with arthrogryposis at birth had been wheelchair bound since the age of six. He had severe contractures of the upper and lower extremities and limb deformities caused by arthrogryposis. He presented with the inability to ambulate and was unable to bring his hand to his mouth. For his lower extremity he underwent multiple releases, pterygium excision, patellar relocation, osteotomies, and external fixation. For his upper extremities he underwent radial head excision, an outerbridge procedure, and ulnar nerve transposition. Understanding the patient’s underlying strength and potential allowed us to create a treatment plan that would ultimately allow him to independently ambulate and bring his hand to his mouth.