2025 – PAGE 420 – ORTHOPEDICS AND SPORTS MEDICINE
SPORTS INJURY PEARL
Once sports injury patients are pain-free, without swelling, and have regained full range of motion and strength, they can be cleared to return to sports. If pain persists and a previous X-ray was negative for a fracture, repeat the X-ray in case of an occult fracture.
CONGENITAL TORTICOLLIS
Children with congenital torticollis are born with a damaged or shortened sternocleidomastoid muscle. The head will be tilted to the ipsilateral side, and the chin will point to the other side. Treat with daily stretching and physical therapy to improve the range of motion. If it doesn’t improve by a year of age, consider surgery.
PEARL: There is an odd association with developmental dysplasia of the hip (DDH). Don’t get it confused with Klippel-Feil Syndrome, in which there are fused cervical vertebrae, a webbed neck, more severe limitation in the range of motion, and possibly other anomalies. And don’t get that confused with Klippel-Trenaunay Syndrome, in which there is a port wine stain and overgrowth/hemihypertrophy issues.
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POLYDACTYLY
Polydactyly refers to the presence of extra digits. Preaxial refers to the radial side, while postaxial refers to the ulnar side. Many of these extra digits are barely hanging on and have no bone in them. They can simply be tied off with suture. If they are well-formed, obtain a surgical consult.
- PREAXIAL SUPERNUMERARY DIGITS(AKA AXIAL SUPERNUMERARY DIGITS): These are located on the 1st digit (thumb) and are more likely associated with certain syndromes (low-yield).
- POSTAXIAL SUPERNUMERARY DIGITS: These are located on the 5th digit (pinky finger) and are less likely to be associated with a syndrome.