Sankar Wudbhav N, Weiss Jennifer, Skaggs David L
Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mail Stop 69, Los Angeles, CA 90027, USA.
J Am Acad Orthop Surg. 2009 Feb;17(2):112-22. doi: 10.5435/00124635-200902000-00007.
The occasional consultation on a neonate can be unfamiliar territory for many orthopaedic surgeons. Just as children are not little adults, newborns are not just little children; rather, they have a unique physiology that affects the presentation of their orthopaedic concerns. Careful physical examination with appropriate understanding of neonatal development is essential to making the proper diagnosis. A flail extremity in the newborn is most commonly attributed to fracture or brachial plexus palsy; however, infection must also be considered and ruled out to prevent long-term morbidity. Metatarsus adductus is the most common foot abnormality, but clubfoot, calcaneovalgus deformity, and congenital vertical talus may also be encountered. Joint contractures that spontaneously improve are normal in the newborn, but it is important to identify and institute proper treatment for early developmental dysplasia of the hip, congenital knee dislocation, and torticollis. Clavicular pseudarthrosis and periosteal reactions may be discovered on radiographic examination. A basic understanding of the relevant conditions will help the orthopaedist with the initial diagnosis and management of orthopaedic issues in the newborn.
对于许多骨科医生来说，偶尔会诊新生儿可能是一个陌生的领域。正如儿童不是小成年人一样，新生儿也不只是小孩子；相反，他们有独特的生理机能，这会影响其骨科问题的表现形式。在适当理解新生儿发育情况的基础上进行仔细的体格检查对于做出正确诊断至关重要。新生儿的连枷状肢体最常见的原因是骨折或臂丛神经麻痹；然而，也必须考虑并排除感染，以防止长期发病。内收足是最常见的足部异常，但也可能会遇到马蹄内翻足、跟骨外翻畸形和先天性垂直距骨。新生儿中会自发改善的关节挛缩是正常现象，但识别并对早期发育性髋关节发育不良、先天性膝关节脱位和斜颈进行适当治疗很重要。在影像学检查中可能会发现锁骨假关节和骨膜反应。对相关病症有基本的了解将有助于骨科医生对新生儿的骨科问题进行初步诊断和处理。
