This 2009 JAAOS review by Sankar, Weiss, and Skaggs addresses the full spectrum of orthopaedic conditions encountered on neonatal consultation — from the flail extremity triad to foot deformities, DDH, congenital knee dislocation, torticollis, and unusual radiographic findings — with a focus on diagnosis and initial management in a population whose physiology differs fundamentally from older children.
When you're called to the NICU for a baby not moving a limb, work through infection first — normal-appearing labs don't rule it out, and the shake test is your quickest bedside discriminator.
When you find DDH, set the Pavlik harness at 100°/60°, confirm reduction by ultrasound at 2–3 weeks, and stop the harness at 4 weeks if still dislocated — prolonged use in a dislocated hip erodes the posterior acetabulum and makes reduction harder.
This 2009 JAAOS review by Sankar, Weiss, and Skaggs addresses the full spectrum of orthopaedic conditions encountered on neonatal consultation — from the flail extremity triad to foot deformities, DDH, congenital knee dislocation, torticollis, and unusual radiographic findings — with a focus on diagnosis and initial management in a population whose physiology differs fundamentally from older children.
When you're called to the NICU for a baby not moving a limb, work through infection first — normal-appearing labs don't rule it out, and the shake test is your quickest bedside discriminator.
When you find DDH, set the Pavlik harness at 100°/60°, confirm reduction by ultrasound at 2–3 weeks, and stop the harness at 4 weeks if still dislocated — prolonged use in a dislocated hip erodes the posterior acetabulum and makes reduction harder.