Orthopaed. 01.09.01

                                                    DOWN'S SYNDROME:
                 ORTHOPAEDIC ABNORMALITIES IN ADULTS


Radiological changes in 129 adults age 20-59 years (USA).
Severity of radiological changes not matched by clinical
state. only 3% complained of pain. 5% required surgical
intervention

·  Diffuse degenerative changes in cervical spine                                                                                                    33%
·  Cervical subluxations at every level                                                                                                              23%
      - neurological sequelae rare
· Scoliosis                                                                                                                                          40%
·  Degenerative changes in thoracolumbarspine                                                                                                        21%
       - probably secondary to scoliosis
· Degenerative arthritis:
                           hip                                                                                                                       10%
                           knee                                                                                                                      12%
                           foot                                                                                                                      18%
                           ankle                                                                                                                       5%

(From: Christopherson et al (1986) Orthopaedic abnormalities of adults
with Down's syndrome. Dev. Med Child Neurol. P103)



265 adults:  Clinical and radiological assessment:
Management issues discussed
.Most critical problems:
     ·               Severe hallux valgus
     ·               Metatarsus primus varus
     ·               Subluxation and dislocation of the patella
     ·               Severe pes planus
     ·               Atlanto axial subluxation
     ·               Femoral head epiphysiolysis
     ·               Dislocation or subluxation of the hips.

(From: Diamond et al (1981) Orthopaedic disorders in patients with
Down's syndrome. Orthopaedic clinics of North America. 12 1 p57 ­71)


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DSMIG (UK) 2001   www.dsmig.org.uk                                                                                                                           14.01.02