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Orthopedic

Orthopedic issues in M-CM are related to limb asymmetry, loose joints and hypotonia.  Young patients often benefit from physical therapy. Some need the support of leg or ankle braces. 

For patients with a leg length difference, a shoe lift can help to alleviate problems if one leg is longer than the other.  A surgical procedure called an epiphysiodesis can be performed to stop the growth in the larger leg so that the shorter leg can catch up, alleviating a leg length discrepancy by the time growth is complete. An orthopedist follows growth and bone age in a patient over time in order to perform this procedure at the optimal moment. 

There is an increased risk of hip dislocations at birth.  Hip dislocation is sometimes effectively treated in infants with a brace but surgical intervention can be necessary.  

There is also an elevated rate of scoliosis in M-CM patients. Scoliosis is sometimes identified and treated surgically at a young age, and sometimes it emerges with puberty. Contributing factors may be body asymmetry and hypotonia.