Arthrogryposis

  • Diffuse group of syndromes
  1. Arthrogryposis – involves all four extremities
  2. Distal Arthrogryposis
  3. Pterygia Syndromes
Arthrogryposis, historical drawing of arthrogryposis multiplex congenita
Historical drawing of arthrogryposis multiplex congenita. Image by Adolph Wilhelm Otto (1786–1845), German anatomist, Wikimedia Commons, Public domain.

Arthrogryposis Multiplex Congenita

Features

  • Featureless tubular limbs
  • Absent skin creases
  • Arms adducted & internally rotated
  • Elbow usually extended
  • Hips flexed abducted & externally rotated
  • Knee usually extended
  • Feet – clubfeet
  • Stiff firm inelastic block to motion
  • 2/3 involve all 4 extremities
  • 1/3 lower extremities predominate
  • major feeding difficulty may occur secondary to stiff jaw
  • intelligence normal
  • clinical exam is best method for diagnosis

Aetiology

  • unknown

Natural History

  • unknown
  • 1/3 scoliosis
  • ¼ non walkers

Treatment

  • goals
    • lower extremity = ambulation
    • upper extremity – ROM for self care
  • early ROM & casting/splinting
  • Hips
    • Unilateral dislocation can be treated
    • Leave bilateral dislocation alone
  • Knee
    • Usually kneeis addressed prior to hip & feet
    • Manipulate & cast
    • Surgery to follow
  • Foot
    • Usually requiring open procedure, rarely vertical talus
  • Upper extremity
    • Consideration to procedures which would get flexion

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.