Congenital Deformities of Mechanical Origin

Browne, Denis

doi:10.1136/adc.30.149.37

Cited by 70 publications

(15 citation statements)

References 3 publications

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“…This work was stimulated by qualitative studies including early clinical observations of cases of torn tentorium cerebelli, subdural cerebral hemorrhage, clubbed feet, head molding, and even brachial plexus injury in a fatal case. [30][31][32] These researchers surmised that some of these conditions were induced by uterine pressures. In a series of classic works from the 1950s, researchers began to quantify contraction strength and found that laboring patients typically contract with pressures between 50 and 100 mm Hg, with peak pressures in the range of 120 mm Hg.…”

Section: The Uterine Forces Of Labormentioning

confidence: 99%

On the Mechanical Aspects of Shoulder Dystocia and Birth Injury

Allen

2007

Clinical Obstetrics &Amp; Gynecology

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This article presents objective evidence about shoulder dystocia and its associated mechanical injuries, namely clavicle fractures, and brachial plexus injuries. Specifically, the review focuses on the mechanical response of the fetus to forces applied to it or its anatomic components, including possible force thresholds for injury. This is followed by presenting the medical and engineering literature on the mechanical aspects of shoulder dystocia with emphasis on kinematics, the forces associated with labor and with traction forces associated with delivery. Finally, the paper discusses the mechanical characteristics of maternal and fetal maneuvers for shoulder dystocia and demonstrates how shoulder dystocia models can be used to train clinicians in the performance of maneuvers that stress the fetus the least. From a mechanical point of view, there are obstetric methods and training that can be employed to reduce the stresses induced by the fetus while alleviating shoulder dystocia, thereby reducing, but not eliminating, the risk of mechanical injury.

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Section: The Uterine Forces Of Labormentioning

confidence: 99%

On the Mechanical Aspects of Shoulder Dystocia and Birth Injury

Allen

2007

Clinical Obstetrics &Amp; Gynecology

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“…Historically, talipes equinovarus and hip dysplasia have been considered to be related 4,5 . However, as the etiologies of the two conditions have been better understood, the link has become less certain 6,7,12 .…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of DDH in the general population varies from 0.14% to 3.5% live births, depending on the study and the method of detection 1,3 . Among children with talipes equinovarus (TEV or clubfoot), the prevalence of DDH was thought to be higher due to the presumption that both result from intrauterine compression 4–6 . As understanding of the etiology of both of these conditions improved, the link became less clear.…”

Section: Introductionmentioning

confidence: 99%

Is It Worthwhile to Routinely Ultrasound Screen Children With Idiopathic Clubfoot for Hip Dysplasia?

Mahan

Yazdy²,

Kasser³

et al. 2013

Journal of Pediatric Orthopaedics

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Purpose Patients with idiopathic clubfoot are considered at increased risk for having developmental dysplasia of the hips (DDH). However, the studies showing this association have been relatively small. Many clinicians who treat idiopathic clubfoot routinely screen the hips of these patients with ultrasound or radiograph due to the concerns of increased risk of DDH. We evaluated a large clubfoot population to determine the risk of DDH and compare this to a population of children without clubfoot. We also evaluated if the clubfoot patients found to have DDH would have been discovered by standard DDH screening. Methods We identified infants in three states (MA, NY, NC) who were reported to each state’s birth defects registry as having a clubfoot. A second cohort of infants without clubfoot was also identified as a control group. Mothers of these children were contacted to be included in the study, and a computer-assisted telephone interview was administered by one of the study nurses, including questions about treatment of DDH. The child’s median age at interview was 7 months. Mothers of clubfoot cases were also contacted for follow-up at mean age of 3.3 years. Results Families of 677 patients with clubfoot and 2037 controls were interviewed. 5/677 (0.74%) patients with clubfoot and 5/2037 (0.25%) controls reported having their infant treated with a brace or harness for hip problems (p=0.134). Of the patients with clubfoot, two of them did not need treatment for their DDH and two would have been discovered by standard hip screening. Follow-up study at 3.3 years of age found no serious late hip dysplasia. Conclusions Treatment of DDH was uncommon in all children; the higher proportion in infants with clubfoot was not statistically different than controls. Of the patients with clubfoot and DDH, standard hip screening would have been appropriate and others did not need treatment. These data suggest that routine hip ultrasound or radiographic screening of idiopathic clubfoot patients is not necessary unless indicated by the standard infant hip screening.

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“…Postural CGR has been associated with oligohydramnios as well as with an abnormal (breech) fetal presentation. 3,4 It has been theorized that persistent malposition in utero contributes to the hyperextension, especially if reduction is prevented by a tight-fitting myometrium, as may be the circumstance in cases of oligohydramnios. 3,4 In our case, the most likely etiology for CGR was the transient oligohydramnios present after the MFPR.…”

Section: Discussionmentioning

confidence: 99%