Purpose of review: The purpose of this review is to update the role of the orthopedic surgeon in the management of Down syndrome as these patients are living longer and participating in sporting activities.
Recent findings: Approximately 20% of all patients with Down syndrome experience orthopedic problems. Upper cervical spine instability has the most potential for morbidity and, consequently, requires close monitoring. Other conditions such as scoliosis, hip instability, patellar instability and foot problems can cause disability if left untreated. In some of these conditions, early diagnosis can prevent severe disability.
Summary: Surgical intervention in children with Down syndrome has a high risk of complications, particularly infection and wound healing problems. Careful anesthetic airway management is needed because of the associated risk of cervical spine instability.
aDivision of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
bDivision of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, USA
cWeill Medical College of Cornell University, Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, USA
Correspondence to Daniel W. Green, MD, Associate Professor of Orthopaedic Surgery, Division of Pediatric Orthopaedic Surgery, 535 East 70th Street Hospital for Special Surgery, New York, NY 10021, USA Tel: +1 215 606 1631; fax: +1 212 774 2776; e-mail: greendw@hss.edu
