Orthopaedics for the Newborn and Young Child: A Practical Clinical Guide

Description

Primary care providers caring for newborns must be able to recognize orthopaedic disorders that affect infants, particularly when these conditions require early treatment or are part of an underlying syndrome.  This book provides pediatricians, neonatologists, family medicine physicians and licensed independent practitioners with a useful framework for the diagnosis and management of common pediatric orthopaedic conditions that typically present during infancy.  The text begins with an overview of orthopaedic embryology and relevant physical examination techniques.  The second section details congenital and developmental conditions affecting the limbs and spine.   The third section includes topics related to birth trauma.  The final section focuses on orthopaedic manifestations of systemic diseases and syndromes.  Each chapter has a consistent, intuitive layout including a brief overview and sections on clinical presentation, evaluation and management, as well as a detailed discussion of the condition being discussed.  When relevant, clinical vignettes are included to illustrate practical application of the subject matter. The design of the sections allow providers to easily reference appropriate information in the clinic setting. Written by experts in the field, Orthopaedics for the Newborn and Young Child is a valuable resource for pediatric orthopaedic providers, primary care physicians and other specialists who treat children.  Preface Acknowledgments Contents Contributors Part I: Overview Chapter 1: Essentials of Embryology for the Musculoskeletal System The Embryonic Period The Fetal Period (8 Weeks-Birth) Development of the Skeletal System Development of Axial Skeleton Development of the Appendicular Skeleton Common Congenital Disorders of Skeletal System The Muscle System Common Disorders of Muscle Development Limb Formation Disorders of Limb Development References Chapter 2: Musculoskeletal Physical Examination of the Newborn Brief Overview Clinical Presentation: History and Physical General Head Neck Shoulders/Clavicle/Scapula Chest and Abdomen Spine Upper Extremity Elbows Hands Hips Lower Extremity Knees and Legs Feet Clinical Vignettes/Pearls Reference Part II: Congenital and Developmental Disorders Chapter 3: Metatarsus Adductus Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Vignettes/Clinical Pearls Natural History, Primary and Secondary Prevention References Chapter 4: Calcaneovalgus Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation Evaluation Management Clinical Vignettes/Clinical Pearls Natural History, Primary and Secondary Prevention References Chapter 5: Congenital Talipes Equinovarus (Clubfoot) Clubfoot (and Positional Equinovarus) Brief Overview Epidemiology Normal Foot Anatomy Pathophysiology Common Clinical Presentation: History and Physical Radiographic Studies/Testing/Evaluation Treatment/Management Natural History, Primary and Secondary Prevention References Chapter 6: Congenital Vertical Talus Brief Overview of Condition Background Including Epidemiology and Pathoanatomy Clinical Presentation: History and Physical Evaluation Management Natural History, Primary and Secondary Prevention References Chapter 7: Congenital Curly Toe Contractures Background Clinical Presentation Testing and Evaluation Treatment Non-operative Management Operative Management Open Tenotomy of FDB Tendon Slip Open Tenotomy of FDB and FDL Tendon Slips Transfer of FDL to Extensor Hood References Chapter 8: Congenital Dislocation of the Knee (CKD) Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Radiographic Evaluation Management Clinical Vignettes/Clinical Pearls Natural History, Primary and Secondary Prevention References Chapter 9: Fibular Hemimelia/Congenital Short Femur/LLE Deformity Introduction Background: Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Pearls References Chapter 10: Developmental Dysplasia of the Hip (DDH) Brief Overview Epidemiology Pathophysiology Normal Anatomy Pathologic Changes Clinical Presentation History and Physical Imaging Management Natural History, Primary and Secondary References Chapter 11: Upper Limb Deficiencies Introduction Radial Deficiencies Clinical Findings Classification Evaluation/Risk Factors Treatment Ulnar Deficiency Clinical Findings Classification Evaluation/Risk Factors Treatment Humeral Deficiency References Chapter 12: Polydactyly and Syndactyly of the Hand Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Polydactyly Radial Polydactyly (Preaxial Polydactyly) Central Polydactyly Ulnar Polydactyly (Postaxial Polydactyly) Mirror Hand Clinical Presentation: History and Physical Syndactyly Evaluation Management Clinical Pearls Polydactyly Syndactyly References Suggested Readings/Additional Resources Chapter 13: Trigger Thumb Background Epidemiology/Pathophysiology Common Clinical Presentation Treatment/Management Current References Including Applicable Position Statements References Chapter 14: Congenital Scoliosis Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Vignettes/Clinical Pearls References Chapter 15: Infantile Idiopathic Scoliosis Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Vignettes/Clinical Pearls References Chapter 16: Congenital Muscular Torticollis Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Vignettes/Clinical Pearls Natural History, Primary and Secondary Prevention References Chapter 17: Arthrogryposis: Overview and Evaluation Overview Classification Epidemiology Pathophysiology Etiology Genetics Clinical Presentation Evaluation Treatment References Chapter 18: Distal Arthrogryposis and Arthrogryposis Syndromes with Diffuse Involvement (Amyoplasia) Brief Overview of Condition Background Including Epidemiology and Pathophysiology Causes for Decreased Fetal Movement Include Incidence Early Identification Clinical Presentation: History and Physical Amyoplasia or Classical Arthrogryposis Common Physical Findings Common Associated Findings Distal Arthrogryposis DA Type 1 DA Type 2A (Freeman-Sheldon Syndrome) DA Type 2B (Sheldon-Hall Syndrome) Radiographic Studies/Testing/Evaluation Treatment/Management Upper Extremities Elbows Fingers Spine Hip Knee Foot Clinical Vignette Birth History Past Medical History Past Surgical History Social History Physical Exam Radiographic Exam Current Therapeutic Program Clinical Pearls Natural History, Primary and Secondary Prevention Amyoplasia References Chapter 19: Larsen Syndrome Description/Background of the Disorder: Brief Overview of Conditions Epidemiology/Pathophysiology Common Clinical Presentation: History and Physical Radiographic Studies/Testing/Evaluation Treatment/Management Clinical Vignettes/Clinical Pearls Natural History, Primary and Secondary Prevention References Chapter 20: Amniotic Band Syndrome Brief Overview of Condition Background, Epidemiology, and Pathophysiology Clinical Presentation: History and Physical Radiographic Studies/Testing/Evaluation Classification Systems Treatment/Management Clinical Vignette Past Surgical History (Performed by Orthopedic and Plastic Surgeons) Social History Physical Exam Current Treatment Program Natural History, Primary and Secondary Prevention References Part III: Birth Trauma Chapter 21: Birth Fractures Background Epidemiology/Pathophysiology Common Clinical Presentation: History and Physical Treatment/Management Natural History: Primary and Secondary Prevention References Chapter 22: Pediatric Brachial Plexus Palsy Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Pearls References Suggested Readings/Additional Resources Part IV: Systemic Conditions and Syndromes with Orthopaedic Manifestations Chapter 23: Achondroplasia Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Thoracolumbar Kyphosis Spinal Stenosis Lower Extremity Angular Deformities Short Stature Limb Lengthening Growth Hormone Other Medical Complications Clinical Vignettes/Clinical Pearls References Chapter 24: Other Osteochondrodysplasias Diastrophic Dysplasia Brief Overview Epidemiology and Pathophysiology Clinical Presentation Evaluation Management Natural History and Prevention Strategies Chondroectodermal Dysplasia (Ellis–van Creveld Syndrome) Brief Overview Epidemiology and Pathophysiology Clinical Presentation Evaluation Management Natural History and Prevention Strategies References Chapter 25: Spondyloepiphyseal Dysplasia Background: Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Pearls References Chapter 26: Juvenile Idiopathic Arthritis Epidemiology/Pathophysiology Clinical Presentation Work-Up Treatment Prognosis Summary Clinical Pearls References Chapter 27: Septic Arthritis Overview Epidemiology Common Clinical Presentation Evaluation Treatment/Management Natural History, Primary and Secondary Prevention References Chapter 28: Pediatric Osteomyelitis Brief Overview Epidemiology Pathophysiology Microbiology Clinical Presentation History and Physical Imaging Laboratory Management Antibiotic Therapy Surgery Natural History Complications References Chapter 29: Orthopedic Manifestations of In Utero Exposures to Teratogens/Infections Epidemiology and Pathology Nicotine Ethanol Tetracycline Anticonvulsants (Phenytoin) Chemotherapeutic Agents Retinoic Acid Thalidomide Ionizing Radiation Mechanical Forces Hyperglycemia: Maternal Diabetes Hyperthermia Arsenic Nitrosable Drugs Infections: TORCH Toxoplasmosis Other: Syphilis and Varicella Congenital Rubella Cytomegalovirus Herpes References Chapter 30: Leukemia in the Newborn and Young Child Overview and Epidemiology Pathophysiology Common Clinical Presentation Evaluation and Diagnosis Treatment and Management Orthopedic Manifestations Primary Musculoskeletal Signs and Symptoms Bone Pain Limping Joint Pain Secondary Musculoskeletal Signs and Symptoms Radiologic Manifestations and Abnormalities Osteoporosis Metaphyseal Bands Lytic Bone Lesions Osteosclerosis Periosteal Reactions Pathologic Fractures Avascular Necrosis (AVN) Conclusion References Chapter 31: Orthopaedic Manifestations of Hematologic Disorders: Sickle Cell Disease and Hemophilia Sickle Cell Disease Orthopedic Manifestations of Sickle Cell Disease Vaso-occlusive Crisis (“Pain Crisis”) Avascular Necrosis (AVN) Osteomyelitis and Septic Arthritis Hemophilia A and B Orthopedic Manifestations of Hemophilia Hemarthrosis (Joint Bleeding) Muscle Hematoma Hemophilic Arthropathy References Chapter 32: Langerhans Cell Histiocytosis Brief Overview Background Clinical Presentation: History and Physical Evaluation Management Unifocal Bony Disease Multifocal Bony Disease Systemic Treatment Orthopedic Sequelae and Management Clinical Pearls Resources References Chapter 33: Myelomeningocele Background Epidemiology/Pathophysiology Common Clinical Presentation: History and Physical Radiographic Studies/Testing/Evaluation Detailed Description of Condition Treatment/Management Clinical Pearls References Chapter 34: Spinal Muscular Atrophy Epidemiology and Pathophysiology Clinical Presentation: History and Physical Radiographic Studies/Testing/Evaluation Treatment/Management Use of Physical Therapy and Orthoses Nonoperative Management of Scoliosis Operative Management of Hip Instability Operative Management of Scoliosis Clinical Pearls References Chapter 35: Duchenne Muscular Dystrophy Brief Overview of the Condition Background: Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Vignettes/Clinical Pearls References Chapter 36: Myotonic Dystrophy Background Epidemiology/Pathophysiology of DM1 Common Clinical Presentation General Medical Evaluation and Treatment Neurologic Cardiac Respiratory Ophthalmology Endocrinology Rehabilitation Orthopedic Considerations Motor Impairments Spine Conditions Foot Conditions Contractures Lower Extremity Torsion Deformities Anesthesia Considerations Clinical Pearls Conclusions References Chapter 37: Nutritional and Genetic Rickets Introduction Pathophysiology Clinical Findings Recommendations Treatment Genetic Forms of Rickets Hypophosphatemic Rickets Vitamin D-Dependent Rickets (VDDR) Types of VDDR References Chapter 38: Osteogenesis Imperfecta Introduction Epidemiology/Pathophysiology Classification and Clinical Features Diagnostic Workup and Differential Diagnosis Treatment/Management Physical Rehabilitation Surgical Management Pharmacotherapy Gene Therapy References Chapter 39: Diabetes in Pregnancy Background Clinical Presentation of Orthopedic Manifestations: History and Physical History Physical Evaluation of Orthopedic Manifestations Treatment/Management of Orthopedic Manifestations Clinical Vignette Natural History, Primary, and Secondary Prevention References Chapter 40: Down Syndrome Background Epidemiology and Pathophysiology Common Clinical Presentation Genetic Testing Management Orthopedic Conditions Associated with Down Syndrome General Considerations Atlantoaxial Instability and Occipitocervical Instability Hip Instability and Other Hip Conditions Patellofemoral Instability Scoliosis Arthropathy of Down Syndrome Pes Planus Other Foot Conditions Clinical Pearls Conclusion References Chapter 41: Beckwith-Wiedemann Syndrome Overview Epidemiology Common Clinical Presentation Evaluation Treatment/Management Clinical Vignettes Natural History, Primary and Secondary Prevention References Chapter 42: Noonan Syndrome Brief Overview Background Clinical Presentation Appearance Cardiovascular Endocrine Renal/Genitourinary Hematologic/Oncologic Gastrointestinal Lymphatic Dermatologic Musculoskeletal Oral/Dental Neurologic/Ophthalmologic/Auditory Neurocognitive/Behavioral Evaluation Management Summary References Chapter 43: VACTERL Association Brief Overview Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Vertebral Defects Anal Atresia Cardiac Anomalies Tracheoesophageal Abnormalities Renal and Radial Limb (Non-radial) Abnormalities Single Umbilical Artery Evaluation Management Natural History, Primary and Secondary Prevention References Chapter 44: Musculoskeletal Manifestations of Mucopolysaccharidoses Chronology of Typical Initial Orthopedic Manifestations (Figs. 44.1 and 44.2) References Chapter 45: Russell-Silver Syndrome Background Epidemiology Clinical Presentation Craniofacial Gastrointestinal Orthopedic Molecular Presentation Management Growth Restrictions Hypoglycemia Gastrointestinal Orthopedic Psychosocial Conclusion References Chapter 46: Moebius Syndrome Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation C: Cranial Nerves CN VII CN VI CN XII L: Lower Extremity U: Upper Extremity F: Facial Structure T: Thorax D: Delay Speech Difficulties Motor Difficulties Cognitive Delay Evaluation and Management References Chapter 47: Ehlers-Danlos Background Epidemiology/Pathophysiology Clinical Presentation Testing Treatment Clinical Vignettes/Pearls Natural History Prevention References Chapter 48: Klippel-Trenaunay-Weber Syndrome Brief Overview of Condition Background Including Epidemiology and Pathophysiology Clinical Presentation: History and Physical Evaluation Management Clinical Vignette Natural History, Primary and Secondary Prevention References Chapter 49: Neurofibromatosis Brief Overview Epidemiology and Pathophysiology Clinical Presentations Orthopedic Manifestations Skin Manifestations Lisch Nodules Optic Pathway Gliomas (OPGs) Neurofibromas Malignant Peripheral Nerve Sheath Tumors (MPNSTs) Testing and Evaluation Treatment and Management Scoliosis Congenital Pseudarthrosis of the Tibia (CPT) Natural History and Prevention References Chapter 50: Marfan Syndrome Marfan Syndrome Overview Orthopedic Features of Marfan Syndrome Spine Pelvis Extremities Feet References Chapter 51: Turner Syndrome Introduction Epidemiology Pathophysiology Common Clinical Presentation Orthopedic Conditions Commonly Seen in Turner Syndrome Treatment and Management References Suggested Reading Chapter 52: Cerebral Palsy Background Epidemiology/Pathophysiology Common Clinical Presentation: History and Physical Radiographic Studies/Testing/Evaluation Detailed Description of Condition Treatment/Management Clinical Pearls References Index