Orthopaedic Management in Down Syndrome Current Concept Review

Main Article Content

Kyle Rako
Sheena Ranade
Abigail Allen


Down syndrome is the most common chromosomal disorder and typically results from a maternal duplication of chromosome 21 yielding trisomy 21. General features include a flat facial profile, short stature, oblique palpebral fissures, epicanthal folds, and associated medical conditions such as congenital heart disease, vision problems, and hearing loss.  Most musculoskeletal manifestations of Down syndrome are related to generalized ligamentous laxity, joint hypermobility, and hypotonia which can lead to atlantoaxial instability, atlanto-occipital instability, scoliosis, spondylolisthesis, hip dysplasia / instability, patellar instability, pes planus, and hallux valgus.  Importantly, the orthopaedist may also be the first to discover systemic conditions such as hypothyroidism associated with slipped capital femoral epiphysis (SCFE) or leukemia or inflammatory arthritis leading to musculoskeletal pain .  The purpose of this review is to summarize what the orthopaedist needs to remember when evaluating and treating their patients with Down Syndrome.

Article Details

How to Cite
Rako, K. ., Ranade, S., & Allen, A. (2021). Orthopaedic Management in Down Syndrome: Current Concept Review. Journal of the Pediatric Orthopaedic Society of North America, 3(2). https://doi.org/10.55275/JPOSNA-2021-283
General Orthopaedics
Author Biography

Abigail Allen

Dr. Allen is the Chief of Pediatric Orthopaedic Surgery, the Director of the Pediatric Orthopaedic Clinic, and an Assistant Professor at Mount Sinai in the Leni and Peter W. May Department of Orthopaedics. Dr. Allen is a graduate of the Pennsylvania State College of Medicine and completed her orthopaedic surgery residency at Emory University. During her residency, she was selected for one of the most prestigious pediatric orthopaedic fellowships in the country at Rady Children's Hospital affiliated with University of California San Diego.

Dr. Allen's clinical interests include scoliosis, hip disorders, fracture care, and other pediatric conditions. She has presented at meetings, both nationally and internationally in China, Honduras, and Austria. Dr. Allen is a member of the Pediatric Orthopaedic Society of North America and the Scoliosis Research Society.