Joint hyperlaxity prevents relapses in clubfeet treated by Ponseti method-preliminary results.

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Abstract

[Indexed for MEDLINE] 17. FP Essent. 2024 Sep;544:7-11. Musculoskeletal Issues in Children and Adolescents: Abnormal Findings on the Newborn Musculoskeletal Examination. Leggit JC(1), Creech-Organ J(2). Author information: (1)USUHS University Family Health Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland. (2)Saint Louis University (Southwest Illinois) Family Medicine Residency, Belleville, Illinois. Prenatal and delivery history guides a thorough musculoskeletal examination of the newborn. Amniotic bands from amniotic sequence/syndrome typically are apparent on visual inspection but may present as limb amputation. Management is guided by the degree of tissue compromise. Risk factors for birth trauma are maternal obesity, pelvic anomalies, macrosomia, and operative delivery. Fractures of the clavicle, humerus, and femur heal well with few sequelae. Splinting recommendations differ for each. Polydactyly, syndactyly, and clinodactyly are associated with syndromic conditions. In general, most are managed by orthopedists or plastic surgeons. Talipes equinovarus (clubfoot) can be diagnosed on prenatal ultrasonography, and 20% of cases are part of a syndromic condition. Treatment is via the Ponseti method and is followed by bracing, typically until age 5 years. Developmental dysplasia of the hip is a spectrum where the natural course is not clearly defined. Most instability initially discovered spontaneously resolves by age 2 months, and 90% resolves by age 12 months. Abduction splinting results in sustained hip reduction in 90% of infants requiring treatment. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.