Arthrogryposis Multiplex Congenita (AMC) is an umbrella term used to refer to more than 300 rare congenital disorders characterised by non-progressive joint contractures and a normal sensory system.
The most common subtype of AMC is amyoplasia which includes multiple joint contractures with symmetrically-positioned upper and lower limbs, and the prevalence of fibrous and fatty tissues in place of muscles.
According to Åsa Bartonek, from the Astrid Lindgren Children’s Hospital in Sweden, AMC can be classified into three groups – disorders involving limbs, disorders involving limbs and associated organs, and disorders involving limbs with central nervous dysfunction.
The author notes that there is a possibility of a plantigrade foot position in children with AMC in addition to limited joint range of motion, particularly in the knees and hips. Hip deformities are commonly observed in children with amyoplasia, ranging from soft-tissue contractures to hip dislocation.
Based on a study consisting of 83 children in total, the author recommends an orthotic management of the condition with corrective splinting during growth to achieve functional ambulation and to support the lower extremities in an aligned position.
Contractures in AMC can require multiple surgical corrections of a number of joints such as correction of spinal and foot deformities. An early multidisciplinary intervention is recommended to help a child attain maximum possible function.
Kowalczyk and Feluś state the goals of early management strategies as – improvement of motion in any affected joints, improvement of active motion by strengthening any functional muscles as the limb function in arthrogryposis depends on the capability to move the limb actively, and finally correction of fixed deformities that affect activities of daily living.
Treatment programmes need to be individualised to include physiotherapy, manipulation of contractures, customised orthotic management and a broad spectrum of surgical techniques for correction of musculoskeletal deformities.
MASS4D® custom foot orthotics may contribute to rehabilitation efforts by working in conjunction with multiple orthoses to control compensatory abnormal movements of the feet while helping the patient remain ambulatory for as long as possible.
In addition to improving mobility in the individual, MASS4D® also helps in enhancing postural alignment for healthy functioning of the feet and the overall musculoskeletal system.
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Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players.