Neonatal Displaced Epiphysiolisis of Humeral Head: Case Report
Tabet Al-Sadek1*, A Al-Sadek2, G Dimitrov3, K Marinov4
1Department of
Orthopedics and Traumatology, Belhoul European Hospital, Dubai, UAE
2Medical
University of Sofia, Bulgaria
3Department
of Orthopedics and Traumatology, Medical University of Pleven, Bulgaria
4Department of Special Surgery / Thoracic Surgery, Vascular Surgery, Pediatric Surgery and Orthopedics and Traumatology University Hospital, Stara Zagora, Bulgaria
*Corresponding author: Tabet Al-Sadek, Belhoul European Hospital, Dubai, UAE. Tel:+971551503964; Email: drthabet@abv.bg
Received
Date: 13August, 2017; Accepted Date: 28 August,
2017; Published Date:04September, 2017
Citation: Al-Sadek T, Al-Sadek A, Dimitrov G, Marinov K(2017) Neonatal Displaced Epiphysiolisis of Humeral Head: Case Report. J Orthop Res Ther 2017: 148. DOI: 10.29011/2575-8241.000148
1.
Abstract
1.1. Purpose: In our case, we present a 1-day old baby girl, without complications during delivery reported, presented left shoulder deformity and flaccid paralysis in her left upper limb.
1.2. Methods: A closed reduction was performed under general sedation in Neonatal Intensive Care Unit. Control radiography and sonography showed a good reduction.
1.3. Results: Despite Humeral head ossification nucleus asymmetry, at 6 months, the patient was asymptomatic and recovered full range of movement.
1.4. Conclusion: Early closed reduction looks to be a good method of treatment for these types of deformities.
2.
Keywords:
Displaced;Epiphysiolysis;
Neonatal
1. Introduction
Neonatal traumatic epiphysiolisis of the humeral hear is rare, and only a few cases are reported in the literature. [1,2].Incidence of bone injury during the process of delivery is 1 per 1000 live births [3]. In a matter of frequency, the clavicle is the most common bone fractured (45,7%) followed by humerus (20%), femur (14,3%) and depressed skull fracture (11,4%)[3]. Lack of antenatal care, malpresentation often leading to obstructed labor and operative deliveries were found to be risk factors for bone injuries [3].
2. Case Presentation
In
our case, we present a 1-day old baby girl, without complications during
delivery reported, presented left shoulder deformity and flaccid paralysis in
her left upper limb(Figure 1&2).
3. Materials and Methods
A
closed reduction was performed under general sedation in Neonatal Intensive
Care Unit. Control radiography and sonography showed a good reduction.The
patient was immobilized for 3 weeks with a velpeau, except for physiotherapy
exercises. Radiography and Electromyographic(EMG) controls were performed at
1,3 and 6 months(Figure 3&4).
4. Results
Despite
Humeral head ossification nucleus asymmetry, at 6 months, the patient was
asymptomatic and recovered full range of movement(Figure
5).
5. Discussion and Conclusion
·
Are
MRI and EMG necessary to obtain a complete diagnosis and improve our final
results?
·
Early
closed reduction looks to be a good method of treatment.
·
For
how long is immobilization mandatory?
·
Long
term evolution of gleno-humeral articulation will be affected by humeral head
ossification nucleus asymmetry observed?
Figure 1:1-day old infant
presented with left shoulder deformity and flaccid paralysis in her left upper
limb.
Figure 2: Diagnostic
radiographs showing and displaced epiphysiolysis.
Figure 3:1-month control radiographs. Figure 4: 3 months control radiographs
Figure 5: 6 months
control radiographs.