Scoliosis
المؤلف:
FRANK GARVEY AND JACKY VINCENT
المصدر:
Caring for People with Learning Disabilities
الجزء والصفحة:
P125-C8
2025-10-20
224
Scoliosis
This is another condition associated with the spine in adults with Down’s syndrome. It means curvature of the spine to the side. While it appears to be more common in adults with Down’s syndrome, the exact incidence isn’t known. In the era when almost all children with Down’s syndrome were institutionalized, scoliosis may have been seen in up to half of them as they became adolescents. Bracing is the initial treatment of scoliosis but if necessary, as determined by the orthopedic surgeon, this can be followed by surgical intervention.
HIP
Legg–Calve–Perthes (LCP) is a disorder of the hip, in which the head of the femur loses its blood supply and the bone becomes weak and misshapen. LCP is slightly more common in children with Down’s syndrome than in the general population. This condition usually presents as a painless limp and loss of full range of movement of the involved hip. It is diagnosed through x-rays. Mild cases or cases discovered early may be treated with a combination of bed rest, orthotics and casting. Severe cases require surgical correction.
Slipped capital femoral epiphysis (SCFE, also called epiphysiolysis) can be seen in adults with Down’s syndrome less frequently. In this condition, the rounded head of the femur slides on the neck of the femur. This condition can be associated with obesity and hypothyroidism, both of which are common in teenagers and adults with Down’s syndrome. SCFE appears as a limp with associated pain in the hip or knee (hip conditions often cause knee pain instead of hip pain), and is treated by surgical replacement of the femur.
KNEE
Instability of the patella (kneecap) has been estimated to occur in almost 20 per cent of adults with Down’s syndrome. The majority of cases of instability present only as kneecaps that can be moved further to the outside than the normal kneecap (subluxation); however, some adults can have their kneecaps completely moved out of position (dislocation) and some may even have a hard time getting them back into the right position. Mild subluxation of the kneecap is not associated with pain, but dislocation may be painful. While adults with instability of the patella are able to walk, there is often a decreased range of motion of the knee, with an accompanying change in gait. The longer that nothing is done for the instability, the worse the condition will get over time. Orthoses (special braces) may be useful for mild cases, but severe cases require surgical correction.
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