Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 10 4 2024 12 30 174 6 Aidin Arabzadeh 1 Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Hossein Azaditalab M.D. Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Hesam Alitaleshi MD, Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mohammad Abbaszadeh Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2024 02 11 2024 12 21 Background: Freeman-Burian syndrome (FBS) is a rare genetic disorder characterized by facial deformities, arthrogryposis, and difficulties in orthopedic management. Case Report: A case study of a nine-month-old female patient with FBS is presented, who exhibited facial abnormalities and contractures of the hands and feet. Non-operative treatment, including stretching, massage, and splinting, was initially advised. At nine months, bilateral Achilles tenotomy was performed under local anesthesia due to anesthetic risks. Serial casting and bracing were used to maintain the correction. Conclusion: The authors recommend prompt treatment, especially with non-operative methods, and early training of parents in non-operative therapy for optimal results, as multiple surgeries and anesthetic complications can lead to suboptimal outcomes. Massage, stretching, and achieving stable plantigrade feet are crucial for independent walking in patients with FBS. https://jost.tums.ac.ir/index.php/jost/article/view/568 https://jost.tums.ac.ir/index.php/jost/article/download/568/393