Developmental Disorders Flashcards
What is the most common congenital fusion? What can this cause later in life?
Tarsal coalition- may cause painful flat feet
What is the treatment for tarsal coalition?
Surgical division
How can congenital developmental disorders occur?
Can be genetic (autosomal dominant) or an insult to the developing limb bud at 4-6 weeks gestation
What is syndactyly?
Failure of separation of 2 digits
Most cases of syndactyly require surgical separation at what age?
3/4
What is polydactyly? How should this be treated?
An extra digit, should be surgically removed
What is fibular hemimelia?
The partial or complete absence of the fibula
As well as the fibula, what else may be missing in fibular hemimelia?
The lateral 2 metatarsals
What deformities is fibular hemimelia associated with?
Shortening of the leg, bowing of the tibia, deformities of the ankle
How are mild cases of fibular hemimelia treated?
Limb lengthening (circular frame external fixator)
How are severe cases of fibular hemimelia treated?
Amputation and use of a below knee prosthetic
What is radial club hand?
Absence of the radial bone and sometimes also the thumb
What is proximal focal femoral deficiency? How is this treated?
Bowed and shortened femur, can be lengthened but some require amputation
What are some factors which make obstetric brachial palsies more common?
Large baby, diabetic mum, twin deliveries, shoulder dystocia
What is shoulder dystocia?
The baby’s shoulder catches on the pubic bone
Where does Erb’s palsy affect?
Upper brachial plexus, C5/6
Erb’s palsy results in the weakness and loss of motor innervation of which muscles?
Deltoid, supraspinatus, infraspinatus, biceps and brachialis
How will the upper limb look in Erb’s palsy?
Internal rotation (waiter’s tip posture)
Why is the upper limb medially rotated in Erb’s palsy?
Because the subscapularis is not affected
What treatment is required in Erb’s palsy to prevent contractors early on?
Physiotherapy
What implies a good prognosis in cases of Erb’s palsy?
If biceps function has resumed by 6 months
If there is no recovery from Erb’s palsy, this can cause contractures. How can these be treated?
Release contractures and tendon transfers
Which is rarer, Erb’s palsy or Klumpke’s palsy?
Klumpke’s
Where does Klumpke’s palsy affect? How?
Lower brachial plexus, C8/T1 from forceful adduction
What is the result of Klumpke’s palsy?
Paralysis of the intrinsic hand muscles and possible paralysis of the wrist and finger flexors
Klumpke’s palsy can result in Horner’s syndrome. How?
Due to interruption of the 1st sympathetic ganglion at T1
What is the recovery rate for Klumpke’s palsy? What is the treatment?
50% recovery, no specific treatment
What is the classical position of a hand with Klumpke’s palsy?
The fingers are flexed
What type of brachial plexus palsy has the worst prognosis?
Total
