Pediatric Orthopedic Physical Examination of the Infant: A 5-Minute Assessment

Abraham Ganel, MD, Israel Dudkiewicz, MD, Dennis P. Grogan, MD

Disclosures

J Pediatr Health Care. 2003;17(1) 

In This Article

Chest, Abdomen, and Birth Paralysis of the Upper Extremities

Chest and Abdomen

Note development of the chest and appearance of the nipples. Abnormalities in the chest and abdominal regions, together with brachysyndactyly, are indicative of Poland syndrome (Al-Qattan, 2001; Urschel, 2000). Observe the shape of the chest wall and contour of the ribs noting pectus excavatum, or pectus carinatum.

Birth Paralysis of the Upper Extremities

Spontaneous motion of the upper extremities as a brachial plexus injury can be detected immediately after birth. This is more common after a difficult vaginal delivery of a large infant. Erb's palsy, or injury to the roots of C5 and C6, manifests with deltoid, supraspinatus, infraspinatus injury and no spontaneous abduction or elevation of the arm, or elbow flexion, but with normal motion of the fingers. Klumpke's palsy, or an injury to the lower roots of C8 and T1, manifests with normal shoulder and elbow motion, but paralysis of the intrinsic muscles of the hand with the wrist and fingers in flexion.

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