PREVENTION OF FIXED, ANGULAR KYPHOSIS IN ACHONDROPLASIA

Transient kyphotic deformity arises in most infants with achondroplasi a. In a minority, a fixed and angular kyphosis develops, which can cau se serious neurologic sequelae later in life. We assessed a protocol f or preventing development of such fixed kyphosis in a sequential. unse lected series of 66 infants with achondroplasia. This study demonstrat es the efficacy of early prohibition of unsupported sitting and, in th ose in whom such prohibition proves insufficient, use of bracing. When the proposed algorithm was followed, none of the infants had developm ent of a progressive kyphotic deformity. On this basis, it appears tha t the secondary risks of angular kyphosis, previously estimated to be between 10 and 15% in individuals with achondroplasia, can be complete ly eliminated.