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新生儿单侧足下垂的多学科居家管理:一例报告

Multidisciplinary and home-based management in neonatal unilateral foot drop: a case report.

作者信息

Sanzarello Ilaria, Siracusano Lorenza, Alito Angelo, De Domenico Carmela, Nanni Matteo, Leonetti Danilo

机构信息

Department of Biomedical, Dental and Morphological and Functional Images, Section of Orthopaedic and Traumatology, University of Messina, Messina, Italy.

IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy.

出版信息

Front Rehabil Sci. 2025 May 20;6:1575708. doi: 10.3389/fresc.2025.1575708. eCollection 2025.

Abstract

BACKGROUND

Foot drop in newborns is a rare condition with limited cases reported in the literature. It can result from various aetiologies including neurological, muscular, anatomical, or mechanical factors. Diagnosis can be challenging as identifying the underlying cause is essential for determining the appropriate course of management.

CASE PRESENTATION

We present the case of a newborn with unilateral foot drop highlighting the diagnostic approach and clinical progression. Clinical evaluation and instrumental examinations, including electromyography and nerve conduction studies, showed isolated external popliteal of the sciatic nerve dysfunction. There were no associated spinal cord or musculoskeletal abnormalities. A prolonged and complicated delivery, with sustained intrauterine limb malposition and nerve compression, was identified as the likely cause, leading to transient ischemia and peripheral nerve impairment. Despite the initial weakness and inability to dorsiflex the foot, no surgical or pharmacological intervention was required. Supportive care and close clinical monitoring were adopted besides the active involvement of parents in foot positioning and mobilization. Over the following months, gradual neurological recovery was observed, culminating in the complete resolution of symptoms by the fifth month of life.

CONCLUSION

This case underscores the importance of recognizing transient peroneal nerve palsy as a potential cause of neonatal foot drop. It also highlights the role of conservative management and expectant observation in cases where spontaneous recovery is likely, avoiding unnecessary interventions.

摘要

背景

新生儿足下垂是一种罕见病症,文献报道的病例有限。它可由多种病因引起,包括神经、肌肉、解剖或机械因素。由于确定潜在病因对于确定适当的治疗方案至关重要,因此诊断可能具有挑战性。

病例介绍

我们介绍了一例单侧足下垂新生儿病例,重点介绍了诊断方法和临床进展。临床评估和包括肌电图和神经传导研究在内的仪器检查显示,坐骨神经的腓总神经孤立性功能障碍。没有相关的脊髓或肌肉骨骼异常。一次延长且复杂的分娩过程,伴有持续的子宫内肢体位置异常和神经受压,被确定为可能的原因,导致短暂性缺血和周围神经损伤。尽管最初足部无力且无法背屈,但无需手术或药物干预。除了让父母积极参与足部定位和活动外,还采取了支持性护理和密切的临床监测。在接下来的几个月里,观察到神经逐渐恢复,到出生后第五个月症状完全消失。

结论

该病例强调了认识到短暂性腓总神经麻痹是新生儿足下垂潜在病因的重要性。它还突出了在可能自发恢复的情况下保守治疗和观察等待的作用,避免不必要的干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e80/12129761/a19a2c8fb46c/fresc-06-1575708-g001.jpg

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