This is called contracture. The ankles are usually affected early, then the hips and knees and lastly the joints of the upper limbs. Physiotherapy and occupational therapy are directed against this complication. The physiotherapist advises on exercises to stretch the joints and the occupational therapist on good and bad sitting positions and activities. Surgery is sometimes used to correct contractures.
Medical opinions vary as to when surgery is advisable.
Curvature of the spine is a serious complication. It is called scoliosis . It is a curvature to the side, convex to one side and concave to the other. This is accompanied by rotation of the spine and, because the ribs are attached to the rotated spine, the chest wall becomes more prominent on one side. Scoliosis , if severe, can be uncomfortable or painful and limits the function of the lungs and the upper limbs.