Related Experiment Videos
[Orthopaedic examination of 1 500 infants in maternity (author's transl)]
Insights
Newborn screening reveals common foot dorsiflexion and identifies rotatory knee instability in 2% of infants. Early detection of hip instability (1.7%) and adductor hypertonicity is crucial for preventing deformities.
Area of Science:
- Orthopaedic surgery
- Neonatal screening
- Developmental pediatrics
Context:
- Routine neonatal examinations are critical for early detection of musculoskeletal abnormalities.
- Understanding typical fetal positioning informs the classification of congenital foot deformities.
- Assessing infant lower limb development requires specialized orthopaedic expertise.
Purpose:
- To classify congenital foot deformities based on in utero positioning.
- To investigate the incidence of rotatory knee instability and hip instability in newborns.
- To establish the relationship between birth posture and lower limb orthopaedic deformities.
Summary:
- Examination of 1500 infants identified fetal dorsiflexion as the typical foot position, leading to a proposed new classification of foot deformities.
- Rotatory knee instability was found in 2% of infants, with some cases presenting as dislocations.
- Hip instability was detected in 1.7% of infants, with varying clinical signs including "ressaut" and "piston" displacement. The study highlights the importance of identifying pelvic obliquity and bilateral adductor hypertonicity in conjunction with hip instability.
Impact:
- Provides a novel classification system for congenital foot deformities.
- Increases awareness of less common neonatal knee and hip instabilities.
- Emphasizes the clinical significance of detecting hip instability and associated adductor hypertonicity for timely intervention and prevention of long-term complications.
Abstract:
1 500 infants have been examined by two orthopaedic surgeons within forty eight hours. The examination of the feet has showed that the usual position in utero was the dorsiflexion. A new classification of deformities of the feet is proposed. The examination of the knees has permitted to discover a rotatory instability between the femur and the tibia in 2% of the infants. Some of them were actual dislocations. During the examination of the hips, it has been researched an instability; the passive abduction, the tension of the adductors and an abduction contracture have been analysed. Some instable hips are easy to detect because there is a jerk (ressaut) but others are very difficult because there is no snapping sign but only a telescoping displacement (piston). The rate of unstable hips was 1.7%. As the combination of an unstable hip and an adductor hypertonicity is usual it is very important to detect a pelvic obliquity and a bilateral adductor-hypertonicity. The various forms of normal birth postures and the relation to orthopaedic deformities of the inferior limbs are studied.