A NEWLY developed UK consensus guideline outlines critical recommendations for the orthopedic management of children and young people with Duchenne muscular dystrophy (DMD), addressing an urgent need for standardized fracture and surgical care. The guidance aims to support consistent, high-quality treatment for this population, who face unique orthopedic challenges due to progressive muscle weakness, increased bone fragility, and frequent corticosteroid use.
Patients with DMD are at elevated risk of contractures and falls, which, when combined with reduced weight-bearing and corticosteroid-related bone loss, result in significantly higher fracture susceptibility. Yet despite this well-documented risk profile, orthopedic care for DMD has historically varied widely across treatment centers. The lack of universal standards has led to concerns that many patients may not receive optimal, timely interventions.
To address this gap, DMD Care UK convened an expert working group that developed a comprehensive orthopedic care guideline via consensus. The guidance emphasizes appropriate fracture management, timely decision-making for elective orthopedic procedures, and coordinated multidisciplinary care throughout disease progression. While the recommendations are based on UK practices, they hold relevance for providers internationally, including in the U.S., seeking to elevate the quality and consistency of care for individuals with DMD.
The guideline spans both pediatric and adult populations and has been formally endorsed by the British Society for Children’s Orthopaedic Surgery. This endorsement underscores the rigor and consensus behind the recommendations, which were designed to be practical, adaptable, and rooted in clinical realities.
By establishing a clear framework for fracture prevention and surgical planning, the guidance not only aims to reduce complications but also to improve quality of life for individuals living with Duchenne muscular dystrophy. The authors highlight the importance of early intervention, individualized treatment planning, and shared decision-making among families and providers to optimize outcomes.
As DMD care continues to evolve, this orthopedic guideline marks a key step toward more unified and proactive musculoskeletal management in this complex, high-risk population.
Reference:
Henman PJ et al. Development of a guideline for orthopaedic management in the care of children and young people with Duchenne muscular dystrophy in the UK National Health Service. J Child Orthop. 2025:18632521251348972.
