Developmental Disorders

Question 1

Examples of Developmental Disorders (8)

Answer 1

Syndactyly
Polydactyly
Fibular Hemimelia 
Radial hypoplasia 
Tarsal Coalition 
Brachial Plexus Injury
Erb's Palsy
Klumpke's Palsy

Question 2

Syndactyly

Answer 2

Fusion of 2 digits

Question 3

Syndactyly Treatment

Answer 3

Surgical separation of the digits

Question 4

Polydactyly

Answer 4

Extra digits

Question 5

Polydactyly Treatment

Answer 5

Amputation of least useful digit

Question 6

Fibular Hemimelia

Answer 6

partial or complete absence of the fibula

Question 7

Fibular Hemimelia characteristics

Answer 7

Shortened limb
Bowing of tibia
Ankle deformity
Absence of lateral foot ray

Question 8

Fibular Hemimelia Treatment

Answer 8

Limb lengthening (circular frame external fixator)

Ankle amputation (+use of below knee prosthetic)

Question 9

Radial Hypoplasia

Answer 9

Absence or hypoplasia of the radius

Question 10

Radial hypoplasia characteristics

Answer 10

Underdevelopemt (usually with absence. of the thumb

Marked radial clubbed hand

Question 11

Radial hypoplasia treatment

Answer 11

surgical reconstruction (if thumb is absent, it can be reconstructed from index finger)

deformity correction

Question 12

Tarsal coalition

Answer 12

Fusion of tarsal bones

Abnormal coalition between the talus and calcaneus or the calcaneus and navicular

Can be fibrous, bony or cartilaginous

Question 13

Tarsal coalition symptoms

Answer 13

Painful flat foot

Question 14

Tarsal coalition treatment

Answer 14

Surgical division
Splintage
Orthotics

Question 15

Brachial Plexus Injury Aetiology

Answer 15

Vaginal delivery with

• large baby
• twin deliveries
• shoulder dystocia (difficult delivery of which presents after head has been delivered. Arises when baby’s shoulder becomes compressed against the mother’s pubic symphysis)

Question 16

Erb’s palsy

Answer 16

Weakness or paralysis of the shoulder and arm

Question 17

Erb’s palsy Aetiology

Answer 17

Usually caused by injury to upper roots of brachial plexus during traumatic childbirth

Injury to C5 and C6 nerve roots

Question 18

Erb’s Palsy Symptoms

Answer 18

Loss of innervation to

• deltoif
• supraspinatus
• infraspinatus
• biceps
• brachialis

Waiter’s tip posture

• caused due to. unilateral rotation of humerus
• subscapularis functions and is unopposed as other muscles have no motor. innervation

Question 19

Erb’s Palsy Treatment

Answer 19

Physiotherapy

• Prevent contractors
• recovery begins around 6 months old

Surgery

• If failure to recover
• surgical release of contractures
• tendon transfers

Question 20

Klumpke’s Palsy

Answer 20

Lower brachial plexus injury affecting C8 and T1

Question 21

Klumpke’s Palsy Aetiology

Answer 21

Forceful adduction

Question 22

Klumpke’s palsy Symptoms.

Answer 22

Paralysis of the intrinsic muscles of the hand.
Potentially also finger and wrist flexors.

Horners Syndrome

Question 23

Horners Syndrome

Answer 23

Occurs as there is disruption of the 1st sympathetic ganglion from T1

Characteristics

• Miosis
• Partial ptosis
• Anhidrosis
• Encopthalmus

Question 24

Klumpke’s Palsy Presentation

Answer 24

Flexed Fingers
(Due to paralysis of interossei and lumbricals which assist with PIP extension)

Question 25

Klumpke's Palsy Treatment

Answer 25

No specific treatment 50% recovery rate