OrthoNet

Pseudoparalysis of the Arm

The scenario is the neonate who is not moving his arm

The possibilities:
- fractured clavicle
- fractured proximal humerus
- fractured scapula or acromion
- osteomyelitis of the proximal humerus or clavicle
- septic arthritis of the shoulder
- weird tumour
- brachial plexus palsy

Get a history - birth history - late gestation, huge baby, shoulder dystocia

Look for infection! The proximal humerus contributes about 80% of growth - if you miss the proximal humerus infection that bags the physis, you will severely fuck up the arm.

Check the neurology - is there a discrete or diffuse brachial plexus palsy.