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Clinical manifestations
Achondroplasia patients with short stature is due to the proximal limb shortening caused by; characteristic face: frontal bossing, midface hypoplasia; lumbar extreme forward bending, limited elbow extension and rotation, varus, and fingers was "trigeminal "shape; common knee and stretching over most of the other joints, intelligence is usually normal. The average height of adult male patients was 131 5.6 cm; women 124 5.9 cm.
In infancy, typically mild to moderate cases of the disease decreased muscle tone, motor development capacity is often delayed. Because of decreased muscle tone and head Cause baby it difficult to support the head. The real giant brain in achondroplasia patients, but normal intelligence, unless there is associated with hydrocephalus or other central nervous system complications. Achondroplasia newborn babies often due to head of the natural childbirth increased risk of intracranial hemorrhage caused [Hall et al 1982]. Hydrocephalus may be due to the jugular vein in a narrow hole, S-shaped intracranial venous sinus stenosis led to increased pressure caused by [Pierre-Kahn et al 1980]. Recurrent otitis media is a common problem.
Approximately 7.5% of infants achondroplasia apnea or central apnea disorder and died within the first year [Hecht et al 1987]. Apnea disorder may be caused by midface hypoplasia. Brainstem compression common, can cause respiratory dysfunction, including central sleep apnea [Nelson et al


1988, Gordon 2000]. One study shows that 10% of infants had abnormal cervical spinal cord compression craniocervical junction [Pauli et al 1995]. All had surgery to decompress the craniocervical junction surgery of infants showed a significant improvement in neurological function.
Achondroplasia patients Obesity is a major problem. Manifested early in childhood body weight increased significantly. Prior to 75 cm tall, weight and height of children the average ratio of the average figure for the children and of children is consistent with achondroplasia; reach 75cm or more, the proportion of patients with achondroplasia than the normal population [Hunter et al 1996]. In adulthood, obesity and increased lumbar spinal stenosis caused by non-specific joint problems, cardiovascular complications and promote early death caused by [Hecht et al 1988].
Limited elbow extension in 70% of patients can occur, mainly due to arch the back of the distal humerus, radius front of the back (20% of patients) resulted in elbow extension is more limited [Kitoh et al 2002].
The most common complication in adulthood is related to 1-4 with symptomatic lumbar spinal stenosis [Thomeer
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In general, the doctor will achondroplasia skeletal abnormalities in children to make a comprehensive evaluation, using a dedicated head and body growth and development of the case tracking growth and development of children. If the head start to become too large The doctor should check whether there are children with hydrocephalus, if necessary, will neurosurgeon implanted brain shunt to divert excess brain fluid to relieve pressure on the brain. also be detected in children with skeletal abnormalities, as it spinal tract caused by pressure may result in difficulty breathing, leg pain and numbness. children start to walk after the hump has not subsided, it may be necessary to use surgical correction. curved legs, especially becoming more and more serious or pain caused by bending the legs can also be corrected surgically.
Children with achondroplasia usually placed in the middle ear aqueduct, which helps to prevent frequent ear infections as caused by hearing loss. Congestion caused by the arrangement of teeth may require extra treatment of dental problems, security appliance, and one or more teeth pulled. children are often overweight in preschool started. Because overweight may further increase the bone problems, nutritional guidance and should therefore be to prevent the occurrence of obesity. fibula relative to the tibia can result in excessive growth lower limb knee varus angular deformity or affect the appearance of symptoms are possible tibial osteotomy. fibula bone was also reported using fusion to correct angular limb deformities, but the effect is uncertain.

The second example occurred several years ago, I had a junior high guidance counselor should be invited to help assess a country, one regular class boys with behavioral problems. Was some conflict between schools and parents because of the ever diagnosed with attention deficit hyperactivity disorder of the students on campus there were many impulsive, distracted, unable to comply with group rules, in the classroom or destruction of casual items, lack of learning motivation, and even teachers and students there were many words and body movements on the conflict. At that time the school hope parents will agree that special education students placed in classes, regular class teachers in order to reduce distress; parents though not agree with, but for the endless stream of child behavior problems at school, at all times to the disciplinary office dealing with children's problems are deeply helpless. Assessment report is completed, I believe that the student is not intellectually serious gap, but recommended by the school guidance counselor should be involved in his behavioral problems, and referral of appropriate medical res for medical treatment. But later when the school adopted the recommendations of a school social worker (to suffer from attention deficit hyperactivity disorder in children as mentally retarded children), referral to the school's special education placement classes, and used a big ridiculous reason: let him in there (special education classes) as an assistant special education instructor, develop his strength and capacity, to develop his self-confidence.


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