Dear sir,

The purpose of this letter is to ask you whether if you could help us, I'm a father of 3 years old daughter born with some disability in her legs that prevent her from walk, the doctors her made many surgery to her but no improvement in her case.

My daughters began to recognize that she is different from other child and she knew that her legs cannot bare her to play with other child, so her health and her mood began to change to the worse also she became. She barely go out of the house.

Forgive me sir. if I made my litter very long but I don't no what to do,I don't now who to use the internet and I cant even write litter, so I asked some one to write this litter instead of me .

I went to many doctors her in Iraq and they do nothing to my daughters accept making failed surgery to her, and the last  doctor I went to him he told me to keep my daughters at home because there is no benefited of water I have done, I do that and  I kept my daughters at home to prevent her from suffering, but as I said before her cytological health and her mood began to be very bad and I can't bear to see my daughters suffering in front of my eyes.

I enclosed my litter with report about her case and an x-ray to her legs.

Sir. I will be very grateful if you could guide me what to do or where should I go, because her in Iraq as you know, we are in blockade and there is nothing I can do here.  T  

Surgeon notes:

First seen with 90 degree contractures of both knees. Flexor casting and soft tissue release performed with contractures decreased to 30 degrees. Right knee had osteotomy and essentially straightened. Upper limbs are otherwise in good condition. Future surgical corrections may be needed.

Dear Sir,

Thank you for your question and the information. Your daughter appears to be a very beautiful and bright little girl.

It looks like your little one has arthrogryposis multiplex congenita. It's a long name, but I hope that I will be able to explain what it is to you.

The word arthrogryposis means to have "hooked" joints, which means that some of the joints are contracted or "tight". No one really knows the exact cause of this.

This usually starts at birth, and the joints involved have a limited mobility, but the bones are otherwise normal. The muscles and tendons are scarred and tight. The skin over these joints is shiny. The knees are locked in a flexed position, and the hips are stiff.

Despite the problem with the joints, children usually have normal intelligence and a normal life expectancy. Walking is very possible and can be improved upon.

The treatment is with surgery and physical therapy. Surgery involves soft tissue releases (to loosen up the joints), and osteotomies (cutting out of some of the bone). After the surgery (and throughout life), it is very important to wear removable braces to keep the joints from getting tight again, and perform physical therapy (exercises) to maintain good range of motion and strength of the muscles and joints.

You can help your little girl. She does not need to suffer. She just needs some help from you and/or your family.

• Maintain the braces on her throughout the day

• Perform exercises 3 times a day, which consist of mild stretching of the joints

• Help her to walk as much as possible. It will not be easy right away, but she will get better

Also, it is very important for her to see other children and people. There is no need to keep her locked up in the house. The more she sees other children, and the more she can interact with other children, the more she will develop her intelligence and improve her mood.

Encourage her, sing to her, read to her, hug her, kiss her, love her, and tell her that she is a gift from God.

God has given you a gift...a beautiful little girl who has the strength to conquer a challenge.

Dr. Mike

The Children's Pavilion   4405 N. Holland-Sylvania avenue   Suite 102    Toledo, OH 43623    Phone: 419 841 0772 

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