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Orthopaedic Conditions in the Newborn

Dr. Sankar is Fellow, Children’s Hospital Los Angeles, Los Angeles, CA. Dr. Skaggs is Associate Professor, Children’s Hospital Los Angeles. Dr. Weiss is Assistant Professor, Children’s Hospital Los Angeles.

Dr. Skaggs serves as board member, owner, officer, or committee member for the Pediatric Orthopaedic Society of North America and the Scoliosis Research Society. Dr. Skaggs or a member of his immediate family has received research or institutional support from Medtronic Sofamor Danek and Stryker; serves as a paid consultant to or is an employee of Medtronic Sofamor Danek and Stryker; is a member of a speakers bureau or has made presentations on behalf of Medtronic Sofamor Danek, Stryker, and DePuy; and has received other financial or material support from Wolters Kluwer Health. None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Sankar and Dr. Weiss.

Wudbhav N. Sankar, MD, et al

Reprint requests: Dr. Skaggs, Children’s Hospital Los Angeles, 4650 Sunset Boulevard, Mail Stop 69, Los Angeles, CA 90027.

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.