Staged Correction of Hip Contractures, Severe Knee Flexion, and Clubfoot in Arthrogryposis: Enabling Assisted Ambulation.

CASE REPORT: A 10-year-old boy with arthrogryposis multiplex congenita (AMC) presented in a "Buddha position" with severely limited mobility, including bilateral hip, severe knee flexion, and clubfoot deformities. Surgical correction involved (1) bilateral femoral derotation and shortening osteotomies, knee capsulotomies, and soft-tissue releases; (2) gradual left knee extension using an external fixator; and (3) distal femoral extension osteotomies and Verebelyi-Ogston procedures for clubfoot correction. Postoperative recovery involved intensive rehabilitation and orthotic support. Improved lower limb alignment enabled the patient to transition from non-ambulatory to assisted walking with knee-ankle-foot orthosis.

CONCLUSIONS

This proximal-to-distal approach significantly enhances autonomy in AMC patients with severe deformities.