Down syndrome, or Trisomy 21, is the most common genetic disorder caused by a chromosomal abnormality. The presence of three copies of chromosome 21, rather than the usual two, leads to characteristic facial features, developmental delay, intellectual disability, and impaired immune function. Down syndrome is also associated with an increased risk of congenital heart defects, epilepsy, leukemia, and other diseases. Approximately 20% of all patients with Down syndrome have an associated musculoskeletal condition. The main effects of Down syndrome on the musculoskeletal systems are due to ligament laxity, excessive joint flexibility, and loss of muscle tone. Beyond generalized laxity and hypotonia, musculoskeletal manifestations of Down syndrome include cervical spine instability, hip subluxation, patellofemoral instability, scoliosis, and flatfoot deformity (also known as pes planus or pes planovalgus).

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