II. Exam: Digits (Fingers and Toes)
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Supernumerary Digit
- Extra digit without bone most commonly arising from the ulnar aspect of the 5th finger
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Polydactyly
- Congenital extra-digit (with bone)
- Contrast with Supernumerary Digit which does not involve bone
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Syndactyly
- Congenital persistence of webbing between digits
- Clinodactyly
- Fifth digit curvature
- Associated with inherited, isolated trait, as well as Turner Sydrome, Trisomy 21
III. Exam: Upper Extremities
- Single Palmar Crease
- Seen in 3-10% of normal babies
- Also seen in Down Syndrome (Trisomy 21)
- Shoulder and Neck Exam
-
Brachial Plexus Injury related palsy
- Erb Palsy (C5-C7 spinal nerve root traction injury with waiter's tip deformity)
- Klumpke Palsy (C8-T1 spinal nerve root traction injury with full arm paralysis and absent reflexes)
- Klumpke Paralysis (Claw Hand deformity)
IV. Exam: Lower Extremities
- Bowing of legs is normal variation
- Positional deformities of foot
- Foot should be easily replaced to normal position
- Talipes Equinovarus (Clubfoot)
- Metatarsus Adductus (In-Toeing)
- Lateral foot border with C-Curve appearance
- Calcaneovalgus Deformity
-
Congenital Hip Dislocation (developmental hip dysplasia)
- Tests: Ortolani Test, Barlow Maneuver
- Imaging indications (Hip Ultrasound at 6 weeks or Hip XRay at 4 months of age)
- Girls born in Breech position (risk is >10% for Congenital Hip Dysplasia)
- Consider in boys born in Breech position (risk is >2-3% for Congenital Hip Dysplasia)
- Consider in newborns with Family History of Congenital Hip Dysplasia