Neonatal Presentations Flashcards
What are common orthopaedic conditions found in neonates?
Clavicle fracture Humerus fracture Obstetric brachial plexus injury Torticollis DDH Metatarsus adductus Club foot Calcaneovalgus
What are rare orthopaedic conditions found in neonates?
Congenital limb abnormalities
Tibial pseudoarthrosis
Clavicle pseudoarthrosis
What is the treatment for a neonatal clavicle or humeral fracture?
Arm under vest
Beware of skin maceration
Calpol
What is brachial plexus injury associated with?
High birth weight shoulder dystocia Maternal diabetes Forceps delivery Clavicle fractures Prolonged labour
What is torticollis?
Shortening of SCM muscle
What is torticollis associated with?
Plagiocephaly
DDH
Metatarsus adductus
What are the risk factors for torticollis?
Breech or difficult delivery
What are the clinical signs and symptoms of torticollis?
Head is turned and tilted due to tight SCM
Lump often felt in muscle belly
What is the treatment for torticollis?
Physiotherapy
USS hips
Xray of C spine for congenital abnormalities
What is DDH?
Developmental hip dysplasia
What are the risk factors for DDH?
Female First born Breech position Family history Oligo/twin
What are the investigations and tests for DDH?
Barlow
Ortolani
Galeazzi
USS
What are the treatment options for DDH?
Hip abduction brace
What is metatarsus adductus?
Inward deviation of metatarsal bones
What is the assessment for metatarsus adductus?
Hold heel in neutral and abduct the forefoot away from the midline of the foot
Observe the end position of the forefoot in relation to the hindfoot
Look for presence of medial crease
What is the treatment for metatarsus adductus?
Parental stretching
Refer to physio
Severe may need 2-4 weeks of serial casting
What is calcaenovalgus?
Soft tissue contracture foot deformity characterised by excessively dorsiflexed hindfoot its some valgus
What is the treatment for calcaneovalgus?
Self resolving
Passive stretching
Severe, 2 weeks of casting
What are the clinical findings for club foot?
Mild limb length discrepancy
Muscle wasting
Smaller foot
What is a positional club foot?
Intrauterine packing causes abnormal postural position that is entirely passively correctable but springs back
What is a structural club foot?
True bone anatomical misalignment
What is used to score the severity of club foot?
Piriani score
What is the treatment for club foot?
Reassure and discharge (positional)
Serial casting 8 weeks (structural)
What is congenital vertical talus?
Dorsal dislocation of the navicular on the talus
What is the treatment for congenital vertical talus?
Reverse Ponsetti serial casting
