- Associated Conditions:
- ligament laxity
- hypotonia
- mental impairment
- heart disease (50%)
- endocrine disorders (hypothyroidism and diabetes)
- premature aging
-
spinal abnormalities:
-
atlantoaxial rotatory subluxation in Down's syndrome:
- evaluated with
flexion and extension views of spine;
- C1/C2 fusion has a high complication rate in these patients and is usually reserved for patients w/ neurological comprimise (often w/ > 7 mm
of instability demonstrated on flexion/extension views);
-
scoliosis: may develop in upto 50% of patients;
-
spondylolithesis
- references:
-
Complications of posterior arthrodesis of the cervical spine in patients who have Down syndrome.
- Atlantoaxial dislocation in Down's syndrome: Report of 2 cases requiring surgical correction. Kobori M, Takahashi M, Mikawa Y:
Spine 1986;11:195-200.
- Chronic atlantoaxial instability in Down syndrome.
Burke SW, French HG, Roberts JM, et al: J Bone Joint Surg 1985;67A:1356.
- Atlantoaxial instability in individuals with Down's syndrome: A fresh look at the evidence.
Davidson RG: Pediatrics 1988;81:857.
-
Surgical treatment of symptomatic atlantoaxial subluxation in Down's syndrome.
-
hip joint:
-
SCFE
-
hip dysplasia:
- references:
-
Hip disease in adults with Down syndrome.
Hrenko M.T., McCarthy J. C., Goldberg M.J. Journal Bone Joint Surg. 75-B: 604; 1993
-
The hip joint in Down's syndrome. A study of its structure and associated disease.
- Management of dislocation of the hip in Down Syndrome.
Aprin H., Zink W. P., Hall J. E.
Journal of Pediatric Orthopedics. 5: 428; 1985
- Dislocation of the hip in trisomy 21.
Bennet G.C., Rang M., Roye D. P., Aprin H. JBJS. 64-B: 289; 1982
- Total hip replacement in Down's Syndrome.
Skoff H.D., Keggi K.
Orthopedics 10:485; 1987.
- The hip joint in Down's Syndrome.
Shaw E. D., Beals R. K. Clin. Orthop. 278:101; 1992
- Total hip arthroplasty in patients with Down's syndrome.
M. Kioschos et al.
JBJS Vol 81-B. No 3 May 1999. p 436.
-
knee:
-
patella dislocation
- reference:
Treatment of patellofemoral instability in Down's syndrome.
-
feet:
-
planovalgus feet;
- severe planovalgus deformities may lead to midfoot breakdown during childhood, which may at first glance seem to resemble the hindfoot
valgus deformities often seen in cerebral palsy;
- unlike CP, there is probably few indications for surgical reconstruction;
Orthopedic disorders in Down's Syndrome.
Diamond L.S., Lynne D., Sigman B. Orthop. Clin. North Am. 12: 57; 1981
