June 1990

Limp Associated With a Peripheral Neuropathy Secondary to Car Seat Misuse

Author Affiliations

Division of General Pediatrics Department of Pediatrics The Children's Hospital of Philadelphia and The University of Pennsylvania School of Medicine Philadelphia, PA 19104

Am J Dis Child. 1990;144(6):617. doi:10.1001/archpedi.1990.02150300011002

Sir.—Limp or refusal to walk is a common problem encountered in as many as 4% of pediatric patients.1 Although the differential diagnosis is extensive, comprehensive reviews have not included peripheral nerve compression as a cause.1-5 Our patient presented with a limp caused by a femoral nerve injury, apparently resulting from restraint in a restrictive car seat for 5 continuous hours.

Patient Report.—A 19-month-old white male infant presented with a history of refusal to bear weight since the previous day and fever for 6 hours. The child had been in excellent health with normal gait and weight-bearing before beginning a 5-hour car trip the previous day. He had no history of trauma, recent immunizations, rash, arthritis, cellulitis, bruising, increased irritability, or progressive weakness. Otitis media was diagnosed and the patient was given amoxicillin and promethazine hydrochloride. After 3 days of treatment, he was afebrile but he continued

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