Monday, October 30, 2017

Some Limb Deformities in a Newborn

1. Metatarsus adductus. In metatarsus adductus, the forefoot is deviated medially and is slightly supinated. In the normal foot, a line drawn through the hindfoot will pass between the second and third toe. With metatarsus adductus, this line will pass lateral to the third toe. The prognosis is excellent, with most cases of metatarsus adductus resolving spontaneously.


2. Calcaneovalgus. Calcaneovalgus deformity of the foot is commonly associated with lateral tibial torsion. The forefoot is abducted, and the ankle is severely dorsiflexed to where the foot folds against the anterolateral surface of the tibia. The deformity is usually flexible, and the foot can be passively placed in the normal position. Calcaneovalgus deformity of the foot usually resolves spontaneously.


3. Talipes equinovarus. Talipes equinovarus, or club foot, has an incidence of approximately 1.5 in 1,000. Fifty percent of the time, the condition is bilateral. It can be associated with other conditions such as spina bifida and arthrogryposis. The foot turns inward and downward and remains tight in this position. Talipes equinovarus requires immediate evaluation since the timing of corrective casting, if necessary, can affect optimal outcome.



The Hip Joint
The hips require special attention in the newborn period. Early detection of developmental dysplasia of the hip (DDH) is associated with better outcome. In general, developmental dysplasia of the hip refers to an abnormal relationship between the femoral head and the acetabulum. This encompasses instability, subluxation, acetabular dysplasia, and frank dislocation. Risk factors include first-born, female, left side, breech delivery, and family history. DDH can be associated with torticollis, foot abnormalities, and other musculoskeletal disorders.
A complete exam of the hips is imperative. In the older infant, limited range of motion is a common presenting sign.
However, in the newborn, examination of range of motion in the newborn is not adequate for checking stability of the hip.
Two maneuvers are essential to the newborn exam, the Barlow and Ortolani maneuvers . The
optimal method in examining the hips of the newborn is when the infant is relaxed. Always examine the infant with a released diaper. Each hip should be examined separately.

The Ortolani maneuver reduces a dislocated hip. With the infant lying supine, the Ortolani is performed with the index and third finger positioned on the greater trochanter and the thumb positioned on the inner thigh. The other hand should be used to stabilize the pelvis. While the hip is flexed at a 90-degree angle and the leg is kept in a neutral position, abduct the hip and raise the leg anteriorly. With a positive Ortolani sign, this maneuver reduces an already dislocated hip and will produce a “clunk” sensation. This sign is produced by the head of the femur sliding over the edge of the acetabulum and into the socket. The term “click” should not be used and is not a diagnostic term.


The Barlow maneuver is a provocative test to detect those hips that are unstable, that is, able to be displaced from the acetabulum to a dislocated position. As with the Ortolani, one hand performs the maneuver and the other stabilizes the pelvis. The hand positioning is also similar to the Ortolani. Gently adduct the hip while applying a posterior pressure with the weight of the hand. The normal hip will not dislocate but the dislocatable hips will move very smoothly and subtly out of the socket. The second part of the Barlow maneuver is the classical Ortolani test,
that is, abducting the hip and lifting the dislocated femoral head over the rim of the socket.

8 comments:



  1. Am jeremiah, I am testifying about a great hebal man that cured my wife of hepatitis B and liver cirhosis. his name is Dr oniha. My wife was diagnose of hepatities two years ago, i almost spent all i had then, until i saw dr oniha recommendation online, and i call him, then he told me how to get the herb. You can call him on +2347089275769 or email him at dronihaspell@yahoo.com

    ReplyDelete


  2. Am jeremiah, I am testifying about a great hebal man that cured my wife of hepatitis B and liver cirhosis. his name is Dr oniha. My wife was diagnose of hepatities two years ago, i almost spent all i had then, until i saw dr oniha recommendation online, and i call him, then he told me how to get the herb. You can call him on +2347089275769 or email him at dronihaspell@yahoo.com

    ReplyDelete
  3. I was diagnosed with stage 3 breast cancer in August of 2010. A precious friend told me about Dr Itua Herbal Center in West Africa,She gave me his contact number and email address,I contacted him quickly so he give me guaranty that his herbal medicine will cure my cancer and i will be heal forever I said Okay.I ask him about the process for the cure,he ask me to pay for the fees which i did and within 7 working days he sent me the herbal medicine then he instructed me on how to drink it for two weeks to cure.I told Gomez my friend about the herbal medicine so he gave me go ahead to drink it.So after drinking it for two weeks i was cured I'm so grateful and i promise i will recommend anyone with cancer to him and that what i'm doing.Dr Itua Herbal Medicine makes me believes there is a hope for people suffering from,Parkinson's disease,Schizophrenia,Cancer,Scoliosis,Bladder Cancer,Colorectal Cancer,Tach Disease,Ovarian Cancer,Pancreatic Cancer,Breast Cancer,Kidney Cancer,Leukemia,Lung Cancer,Skin Cancer,
    Glaucoma.measles, tetanus, whooping cough, tuberculosis, polio and diphtheria, Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.Alzheimer's disease,Obsessive Compulsive Disorder,
    Dementia.Uterine Cancer,Prostate Cancer,Fibromyalgia,a
    Syndrome Fibrodysplasia ,Parkinson's disease,Epilepsy Dupuytren's disease,
    Diabetes ,Coeliac disease, Angiopathy, Ataxia,Arthritis,Tach Disease,Amyotrophic Lateral Sclerosis,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic diseases.Hiv_ Aids,Herpes,Inflammatory bowel disease ,Copd,Diabetes.
    Here Is His Contact Info......[Email...drituaherbalcenter@gmail.com/ info@drituaherbalcenter.com. Whatsapp...+2348149277967]

    ReplyDelete
  4. I am here to give my testimony about chief dr lucky who helped me in my life, i want to inform the public how i was cured from herpes simplex virus by chief dr lucky, i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on herpes and i saw comment of people talking about how chief dr lucky cured them. when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, am a free person now without problem, my herpes result came out negative. I pray for you chief dr lucky am cured you can also get your self cured my friends if you really need my doctor help, you can reach him now.
    Email: chiefdrlucky@gmail.com Call or What's App +2348132777335
    Website : http://chiefdrluckysolutionhome.website2.me/

    ReplyDelete
  5. I have been cured HIV through Dr Utu African Traditional roots and herbs.
    Why so many people don't succeed in better health is because they have the belief that herbal medicines are primitive and outdated they took time ⌚ in thinking and having much doubt in herbs that can actually better their health naturally. Do you know that thinking and doubting won't solve your health problems?yes of course it won't solve it All you've to do is to stand up again and make the best move in your life. African herbs cures HIV, HSV, CANCERS, INFERTILITY, ASTHMA, PARALYSIS, DIABETES Try a reliable herbalist like Dr Utu and tell him your symptoms and feelings on;
    drutuherbalcure@gmail.com
    CALLING +2347032718477
    WHATSAPP LINE +2347032718477

    ReplyDelete
  6. I have been cured through Dr Oseghale African Traditional roots and herbs.
    Why so many people don't succeed in better health is because they have the belief that herbal medicines are primitive and outdated they took time ?
    in thinking and having much doubt in herbs that can actually better their health naturally.
    Do you know that thinking and doubting won't solve your health problems?yes of course it won't solve it All
    you've to do is to stand up again and make the best move in your life.
    African herbs cures HIV, HSV, CANCERS, INFERTILITY, ASTHMA, PARALYSIS, DIABETES Try a reliable herbalist like Dr oseghale and tell him your symptoms and feelings on;
    Oseghalesunday07@gmail.com
    CALLING +2347062814871
    WHATSAPP LINE +2347062814871

    ReplyDelete
  7. Am here to appreciate Dr Ogudugu for using his herbal medicine to cure my Herpes virus. since 3 years now I have been living with this virus and it has been giving me challenges, I was so perplexed cause i have been taking several drugs to be cured but all of my effort was in vain,one .morning i was browsing through the internet then i saw several testimonies about Dr Ogudugu curing people from Herpes virus and immediately i contacted Dr Ogudugu on his email: greatogudugu@gmail.com, i told him about my troubles and he told me that i must be cured, gave me some instructions and which i rightly followed. so he prepared a herbal medicine for me and sent it to me which i used for 2 weeks and everything was like a dream to me and my Herpes virus was totally gone, why don’t you contact him today and be free from your diseases because he is very good and honest Doctor. contact him via email; greatogudugu@gmail.com or whatsApp him on +2348063739701 !!

    ReplyDelete
  8. DO YOU NEED A PERSONAL/BUSINESS/INVESTMENT LOAN? CONTACT US TODAY VIA WhatsApp +19292227023 Email drbenjaminfinance@gmail.com

    HELLO
    Loan Offer Alert For Everyone! Are you financially down and you need an urgent credit/financial assistance? Or are you in need of a loan to start-up/increase your business or buy your dream house. Are you in search of a legit loan? Tired of Seeking Loans and Mortgages? Have you been turned down by your banks? Have you also been scammed once? Have you lost money to scammers or to Binary Options and Cryptocurrency Trading, We will help you recover your lost money and stolen bitcoin by our security FinanceRecovery Team 100% secured, If you are in financial pains consider your financial trauma over. We Offer LOANS from $3,000.00 Min. to $30,000,000.00 Max. at 2% interest rate NO MATTER YOUR CREDIT SCORE. GET YOUR INSTANT LOAN APPROVAL 100% GUARANTEED TODAY VIA WhatsApp:+19292227023 Email: drbenjaminfinance@gmail.com


    ReplyDelete