Femoral nerve palsy and hip instability in infants with breech birth presentation: a review of the literature and report of 2 cases.

BACKGROUND

Femoral nerve palsy has been described as a result of hip hyperflexion during orthotic treatment for developmental dysplasia of the hip, but femoral nerve palsy in newborns who have not had brace treatment has not been reported.

METHODS

Two cases of femoral nerve palsy after breech lie in utero are reviewed. Neither of these infants had undergone treatment of any sort for the hip.

RESULTS

In both children, Ortolani-positive hip dislocation was encountered. Both were treated with abduction orthoses with lesser hip flexion than the Pavlik-type brace. Nerve recovery was complete, and the hip dysplasia resolved satisfactorily.

CONCLUSIONS

Femoral nerve palsy may be seen after breech lie in utero and may be associated with hip instability. Treatment considerations for the hip must take into account the nerve compromise.

LEVEL OF EVIDENCE: Level IV, case series.