Journal of Orthopedic Research and Therapy (ISSN: 2575-8241)

Article / case report

"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

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.


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

 

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