Disease Description Polyarticular contracture is a syndrome characterized by stiffness of multiple joints throughout the body due to fibrosis of muscles, joint capsules and ligaments. The disease requires multiple surgeries because of the number of joints involved. It has a high recurrence rate after surgery and requires repeated surgeries. The goal of treatment is to increase the range of motion of the affected joints to enable the child to walk independently or with assistance and to maximize the ability to manipulate the upper extremities and hands. Etiology It is generally accepted that the loss of fetal limb motion in utero is the underlying pathogenesis of the disease. It has been shown that many factors, such as injection of certain drugs during pregnancy and viral infections, can cause the loss of fetal limb movement and lead to the development of the disease. Clinical manifestations The clinical manifestations of the disease are very complex. About 50% of the cases involve only the joints of the limbs and mostly the larger joints, while some children have joint contractures with internal organ, head and facial deformities, and possibly joint contractures with neurological abnormalities. Symmetrical stiffness of the joints of the extremities, mostly in flexion but also in extension, is usually observed after birth. There is significant muscle atrophy in the affected limb and cylindrical changes in the knee and elbow joints. When the joint is contracted in the flexed position, the skin and subcutaneous tissues may form web-like deformities. The skin sensation is normal, but the deep tendon reflexes are often diminished or absent. In some children, only the hand and foot are involved, such as a simple flexion deformity of the thumb or little finger. The timing of surgery depends on the nature of the deformity, the degree of deformity, and the age of the patient. For children with lesions involving large joints, early surgical treatment is recommended, usually as early as 3 months of age, with preoperative immobilization in a cast to stretch the tense skin. Because the thumb plays an important role in the development of hand function, surgery for thumb contractures should be performed before the patient is 2 years old. Treatment options include pharmacological and surgical treatment. The methods of pharmacotherapy include soft tissue release, physical therapy, and brace immobilization, while the surgical treatment methods are mainly muscle a tendon displacement, joint or tendon release. It should be noted that brace immobilization treatment should be insisted on in the early stage of surgery and after surgery, so that not only the contracted joint capsule, ligaments and muscles can be released to a certain extent, so that the affected joints can obtain a certain range of motion function, but also the interval of recurrence can be postponed.