DWARFISM
LEARNING OBJECTIVES
By the end of the session the students should be able:
Define dwarfism
State the types of dwarfism
Explain the causes of dwarfism
Describe the medical management of dwarfism
Describe the nursing management of dwarfism
Dwarfism is short stature that results from a
genetic or medical condition.
Dwarfism generally is defined as an adult height
of 4 feet, 10 inches (147 cm) or less. The average
adult height among people with dwarfism is 4
feet, 1 inch (125 cm) for women and 4 feet, 4
inches (132 cm) for men.
TYPES OF DWARFISM
There are two main categories of dwarfism:
Disproportionate dwarfism: This means that a
person has some average-size parts of the body,
such as the head and/or trunk. But they also have
some shorter-than-normal parts of the body, such
as the legs and arms
The most common type of disproportionate
dwarfism—and the most common type of
dwarfism in general—is achondroplasia. This is
when a person has a normal-size torso but short
arms and legs
Proportionate dwarfism: This means that the
person is smaller than average all over. Growth
hormone deficiency dwarfism, primordial
dwarfism, and Seckel syndrome are all types of
proportionate dwarfism.
CAUSES OF DWARFISM
Dwarfism can be caused by a genetic condition. It
can also be caused by a medical or hormonal
condition.
• Familial: If parents and other family members
are short, it can be normal for their child to be
short.
• Genetic mutation: Changes to a person’s DNA.
• Growth hormone deficiency: The brain doesn’t
make enough of the hormone that causes bones
to grow.
• Late bloomer (constitutional delay): Some children are
short earlier in childhood because they’re programmed to
grow later than their peers. There’s sometimes a family
history of a similar pattern of growth.
• Malnutrition: Not having adequate nutrition can affect a
child’s ability to grow.
• Small for gestational age: Most babies that are born small
will catch up with their growth within the first two to three
years of life, but 10% don’t.
SIGNS AND SYMPTOMS OF DWARFISM
• Disproportionate limbs: This means limbs are
shorter than expected, especially in relation to
the torso. In achondroplasia, the upper arms and
thighs are often particularly short.
• Large head with a prominent forehead: The
head may be larger than average, with a
prominent forehead (frontal bossing).
• Flattened nasal bridge: The bridge of the nose
may appear flattened or depressed.
• Short trunk: The torso may be relatively short
compared to the limbs.
• Short fingers: Fingers may be short and stubby,
sometimes with a wide separation between the
middle and ring fingers.
• Joint problems: Individuals with dwarfism may
experience joint pain, stiffness, and an increased risk
of arthritis.
• Spinal issues: Scoliosis (curvature of the spine) or
lordosis (excessive inward curve of the lower back)
can occur.
• Developmental delays: In some cases, there may be
delays in reaching developmental milestones, such as
crawling, walking, or speaking.
• Other health issues: Depending on the specific
type of dwarfism, there may be other health
problems, such as breathing difficulties, hearing
loss, or vision problems.
MANAGEMENT OF DWARFISM
Surgical Management:
• Skeletal Deformities:
Surgery can correct bone malalignments (like
bowed legs), spinal curvatures, and spinal stenosis
(narrowing of the spinal canal).
• Spinal Cord Compression:
Surgical decompression may be necessary to
relieve pressure on the spinal cord caused by
spinal stenosis or bony overgrowth.
• Hydrocephalus:
Shunts can be placed to drain excess cerebrospinal
fluid and relieve pressure on the brain.
• Airway Obstruction:
Surgery to remove tonsils or adenoids, or to widen
the airway, can improve breathing in some
individuals.
Medical Management
• Growth Hormone Therapy:
In cases of dwarfism caused by growth hormone
deficiency, synthetic growth hormone injections can be
used to increase height during childhood.
• Hormone Replacement:
Estrogen therapy may be used in females with Turner
syndrome to initiate puberty and improve growth.
• Management of Complications:
Regular monitoring and treatment of
complications such as ear infections, sleep apnea,
and other orthopedic issues are essential.
• Genetic Counseling:
Genetic counseling is crucial for individuals with
dwarfism and their families to understand the
condition, potential complications, and
reproductive options.
NURSING MANAGEMENT
• Administering Medications:
May include growth hormone injections or medications
to manage specific conditions like diabetes insipidus.
• Assisting with Respiratory Support:
• Providing education on breathing techniques, using
CPAP machines, and monitoring oxygen saturation.
• Providing Wound Care:
If surgical interventions are needed, nurses will
provide wound care and monitor for signs of
infection.
• Supporting Nutritional Needs:
Ensuring adequate nutrition and managing weight
gain, particularly in cases of achondroplasia.
Promoting Independence:
Encouraging self-care activities, providing
adaptive equipment, and modifying the
environment to enhance independence
