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Figure 4.51. Radiograph of the neck showing the cervical cord and spinal injury following breech delivery. Note the fracture dislocation and separation involving C5 and C6.

Figure 4.52. Congenital torticollis is usually not apparent at birth but within the first week a swelling is noted over the sternoclei-domastoid muscle (stenomastoid tumor). This is thought to occur as a result of spasm, hemorrhage or fibrosis. It results in shortening of the sternocleidomastoid muscle and tilting of the head. It is important to recognize since it may cause astigmatism.

Figure 4.53. Fracture of the right clavicle in an infant at the age of 3 days. There was soft tissue swelling but not much callus formation. The baby may be asymptomatic and the first clinical sign may be a swelling over the clavicle from callus formation or there may be pseudoparesis of the upper limb on the affected side.

Figure 4.52. Congenital torticollis is usually not apparent at birth but within the first week a swelling is noted over the sternoclei-domastoid muscle (stenomastoid tumor). This is thought to occur as a result of spasm, hemorrhage or fibrosis. It results in shortening of the sternocleidomastoid muscle and tilting of the head. It is important to recognize since it may cause astigmatism.

4.53

Figure 4.54. This infant did not have die fracture of the left clavicle diagnosed until the age of 10 days but die nurses had noted that die infant was irritable and restless especially when handled. Examination revealed the excessive callus due to a fracture of the left clavicle. In any infant with a fracture of the clavicle one should also check for injury to the brachial plexus, phrenic nerve, recurrent laryngeal nerve, and die sympathetic chain.

Figure 4.54. This infant did not have die fracture of the left clavicle diagnosed until the age of 10 days but die nurses had noted that die infant was irritable and restless especially when handled. Examination revealed the excessive callus due to a fracture of the left clavicle. In any infant with a fracture of the clavicle one should also check for injury to the brachial plexus, phrenic nerve, recurrent laryngeal nerve, and die sympathetic chain.

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