Short-term functional outcome in children with arthrogryposis multiplex congenita after multiple surgeries at an early age

PURPOSE The purpose of this study is to report our short-term functional outcome for 14 children with arthrogryposis multiplex congenita (AMC) who underwent multiple surgical procedures at an early age. METHODS During the period 2002-2010, 14 children (11 males and three females) with AMC underwent multiple surgical procedures to treat deformities of the lower and upper limbs. About 81 procedures were performed, at a rate of 5.9 procedures per child. The mean age at the last follow-up was 5.9 years. The average follow-up period was 3.6 years (range, 1.5-6 years). The functional outcome assessment included walking ability and the activities of daily living for the upper limb function. RESULTS At the last follow-up visit, six (43%) children (four males, two females) with a mean age of 8.3 years (range, 4-15) were independent walkers. Three children (males) with a mean age of 3.5 years (range, 2.5-5) were able to walk, but with support. One child (male), 3 years old, was a household ambulator. Three children (two males, one female) with a mean age of 4.2 years (range, 2.5-6) were nonfunctional ambulators. The last child (male) was nonambulatory at the age of 5 years. Activities of daily living were severely affected in the nonambulatory child. One child in the nonfunctional ambulators group had limitations in the activities of daily living; however, upper limb function was not affected in the remaining 12 children. CONCLUSION We believe that aggressive surgical treatment using multiple operations at an early age can improve the short-term functional and clinical outcomes of children with AMC.