Hahn G
Clin Orthop Relat Res. 1985 Apr(194):104-14.
A precise diagnosis among the types of arthrogryposis must be made. For amyoplasia, the recurrence risk is nonexistent, the natural history favorable. During the first weeks, frequent stretching supported by maintenance casting and splinting of severe or generalized contractures is indicated in a residential multidisciplinary center. The key to deformity is the rigidity of the periarticular structures. With limb growth, contractures progress or recur. The growth years must therefore be dominated by physical management, which consists of stretching, casting, and bracing interspersed by staged soft-tissue procedures. At completion of limb growth, final corrections should be attained by osteotomies. Adolescence should be a time to follow social and prevocational pursuits in preparation for a place in society.
必须对关节挛缩症的类型做出准确诊断。对于先天性多发性关节挛缩症，不存在复发风险，其自然病程良好。在最初几周，建议在住院多学科中心进行频繁的拉伸，并通过维持石膏固定和夹板固定来处理严重或全身性挛缩。畸形的关键在于关节周围结构的僵硬。随着肢体生长，挛缩会进展或复发。因此，在生长阶段必须以物理治疗为主，包括拉伸、石膏固定和支具治疗，期间穿插进行分期软组织手术。在肢体生长完成后，应通过截骨术进行最终矫正。青春期应该是一个参与社交和职业前活动的时期，为融入社会做好准备。
