Advertisement

Decreased Movement of the Upper or Lower Limb in the Neonate

  • Benjamin Joseph

Abstract

Decreased spontaneous movement of a limb in a neonate is to be taken seriously as urgent intervention may be needed in some instances (Waseem et al. 2009). The two reasons for reduction in spontaneous movements are paralysis and pain, and it is the latter that should invoke a sense of urgency in the treating physician. Pain arising from the limb manifests as pseudoparalysis, and the two most common causes are birth trauma (Lam et al. 2002; Matsubara et al. 2008; Morris et al. 2002; Cebesoy et al. 2009; Nakazato et al. 2001; Jacobsen et al. 2009; Lindseth and Rosene 1971; Journeau et al. 2001) and osteoarticular infection (Bulbul et al. 2009; Dessi et al. 2008; Frederiksen et al. 1993). The commonest cause of paralysis in the newborn is obstetric brachial plexus palsy; rarer palsies have been reported in the literature (al-Qattan et al. 1996; Hayman et al. 1999; Goetz 2010). Occasionally, birth palsy may be associated with birth trauma (Journeau et al. 2001) and very rarely with osteoarticular infection (Estienne et al. 2005).

Keywords

Septic Arthritis Spontaneous Movement Shoulder Dystocia Birth Trauma Deep Soft Tissue 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 17.1

Spontaneous movements of both the upper limbs and the left lower limb are seen while the child does not move the right lower limb. The child had septic arthritis of the tight hip.

References

  1. Aigner RM, Fueger GF, Ritter G. Results of three-phase bone scintigraphy and radiography in 20 cases of neonatal osteomyelitis. Nucl Med Commun. 1996;17:20–8.PubMedCrossRefGoogle Scholar
  2. al-Qattan MM, el-Sayed AA, al-Kharfy TM, et al. Obstetrical brachial plexus injury in newborn babies delivered by caesarean section. J Hand Surg Br. 1996;21(2):263–5.PubMedCrossRefGoogle Scholar
  3. Bulbul A, Okan F, Yekeler E, et al. Acute osteomyelitis of the iliac bone presenting with gluteal syndrome in a newborn. Eur J Pediatr. 2009;168:1529–32.PubMedCrossRefGoogle Scholar
  4. Cebesoy FB, Cebesoy O, Incebiyik A. Bilateral femur fracture in a newborn: an extreme complication of cesarean delivery. Arch Gynecol Obstet. 2009;279:73–4.PubMedCrossRefGoogle Scholar
  5. Dessi A, Crisafulli M, Accossu S, et al. Osteo-articular infections in newborns: diagnosis and treatment. J Chemother. 2008;20:542–50.PubMedCrossRefGoogle Scholar
  6. Estienne M, Scaioli V, Zibordi F, et al. Enigmatic osteomyelitis and bilateral upper limb palsy in a neonate. Pediatr Neurol. 2005;32:56–9.PubMedCrossRefGoogle Scholar
  7. Frederiksen B, Christiansen P, Knudsen FU. Acute osteomyelitis and septic arthritis in the neonate, risk factors and outcome. Eur J Pediatr. 1993;152:577–80.PubMedCrossRefGoogle Scholar
  8. Goetz E. Neonatal spinal cord injury after an uncomplicated vaginal delivery. Pediatr Neurol. 2010;42:69–71.PubMedCrossRefGoogle Scholar
  9. Hayman M, Roland EH, Hill A. Newborn radial nerve palsy: report of four cases and review of published reports. Pediatr Neurol. 1999;21:648–51.PubMedCrossRefGoogle Scholar
  10. Jacobsen S, Hansson G, Nathorst-Westfelt J. Traumatic separation of the distal epiphysis of the humerus sustained at birth. J Bone Joint Surg Br. 2009;91:797–802.PubMedCrossRefGoogle Scholar
  11. Jaramillo D, Treves ST, Kasser JR, et al. Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol. 1995;165:399–403.PubMedCrossRefGoogle Scholar
  12. Journeau P, Bourcheix LM, Wagner A, et al. Obstetric dislocation of the thoracic spine: case report and review of the literature. J Pediatr Orthop B. 2001;10:78–80.PubMedCrossRefGoogle Scholar
  13. Lam MH, Wong GY, Lao TT. Reappraisal of neonatal clavicular fracture: relationship between infant size and neonatal morbidity. Obstet Gynecol. 2002;100:115–9.PubMedCrossRefGoogle Scholar
  14. Lindseth RE, Rosene Jr HA. Traumatic separation of the upper femoral epiphysis in a new born infant. J Bone Joint Surg Am. 1971;53:1641–4.PubMedGoogle Scholar
  15. Mah ET, LeQuesne GW, Gent RJ, et al. Ultrasonic features of acute osteomyelitis in children. J Bone Joint Surg Br. 1994;76:969–74.PubMedGoogle Scholar
  16. Matsubara S, Izumi A, Nagai T, et al. Femur fracture during abdominal breech delivery. Arch Gynecol Obstet. 2008;278:195–7.PubMedCrossRefGoogle Scholar
  17. Morris S, Cassidy N, Stephens M, et al. Birth-associated femoral fractures: incidence and outcome. J Pediatr Orthop. 2002;22:27–30.PubMedGoogle Scholar
  18. Nakazato T, Wada I, Tsuchiya D, et al. Clavicle fracture and posterior sternoclavicular dislocation in a newborn. Orthopedics. 2001;24:1169–70.PubMedGoogle Scholar
  19. Offiah AC. Acute osteomyelitis, septic arthritis and discitis: differences between neonates and older children. Eur J Radiol. 2006;60:221–32.PubMedCrossRefGoogle Scholar
  20. Waseem M, Devas G, Laureta E. A neonate with asymmetric arm movements. Pediatr Emerg Care. 2009;25:98–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer India 2015

Authors and Affiliations

  • Benjamin Joseph
    • 1
  1. 1.Aster MedcityKochiIndia

Personalised recommendations