Neuropathic Injuries to the Lower Extremities in Children

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Abstract
Neuropathic injuries of the lower extremities in children due to meningomyelocele, congenital indifference to pain, and peripheral nerve damage were studied in 10 patients. The injuries fell into 4 categories: fractures of the metaphysis and diaphysis of long bones, epiphyseal separation, Charcot joints, and soft-tissue ulceration. These injuries are often unrecognized; untreated, they can lead to severe disability. For patients with impaired sensation, radiographs should be obtained at any sign of localized soft-tissue swelling, warmth, or hyperemia, especially near a joint. Following diagnosis, immobilization of the limb leads to prompt healing of fractures and epiphyseal separation.

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