Refers to a traumatic injury that happens to an infant, child or adolescent. Because of anatomical and physiological differences between children and adults the care and management of this population differs. The management of pediatric trauma depends on a knowledge of the physiological, anatomical, and developmental differences in comparison to an adult patient, this requires expertise in this area. In the pre-hospital setting issues may arise with the treatment of pediatric patients due to a lack of knowledge and resources involved in the treatment of these injuries. Despite the fact there is only a slight variation in outcomes in adult trauma centers, definitive care is best reached at a pediatric trauma center.
Clubfoot describes a range of foot abnormalities usually present at birth (congenital) in which your baby's foot is twisted out of shape or position. In clubfoot, the tissues connecting the muscles to the bone (tendons) are shorter than usual. Clubfoot is a fairly common birth defect and is usually an isolated problem for an otherwise healthy newborn. Clubfoot can be mild or severe. About half of children with clubfoot have it in both feet. If your child has clubfoot, it will make it harder to walk normally, so doctors generally recommend treating it soon after birth. Doctors are usually able to treat clubfoot successfully without surgery, though sometimes children need follow-up surgery later on.
Hip pathology may cause groin pain, referred thigh or knee pain, refusal to bear weight or altered gait in the absence of pain. A young child with an irritable hip poses a diagnostic challenge. Transient synovitis, one of the most common causes of hip pain in children, must be differentiated from septic arthritis. Hip pain may be caused by conditions unique to the growing pediatric skeleton including Perthes disease, slipped capital femoral epiphysis and apophyseal avulsion fractures of the pelvis. Hip pain may also be referred from low back or pelvic pathology. Evaluation and management requires a thorough history and physical exam, and understanding of the pediatric skeleton.
A limb deformity is a deviation from normal anatomy. The' deformity may include abnormalities of length, rotation, translation, or angulation (fable 61-1). Several other components of limb deformity should also be considered in individual cases: deficiency, malformation, contour, circumference, and proportion. To define a deformity, we need a concept of normal anatomy for comparison. In the lower limb, this usually is evaluated from long standing anteroposterior and lateral radiographs.
A congenital disorder, also known as a congenital disease, deformity, birth defect, or anomaly,[1] is a condition existing at or before birth regardless of cause. Of these disorders, those characterized by structural deformities are termed "congenital anomalies" and involve defects in a developing fetus. Birth defects vary widely in cause and symptoms. Birth defects may be the result of genetic or environmental factors. This includes errors of morphogenesis, infection, epigenetic modifications on a parental germline, or a chromosomal abnormality. The outcome of the disorder will depend on complex interactions between the pre-natal deficit and the post-natal environment. . Acquired Deformity: An acquired deformity is a change in the normal size or shape of a body part as a result of an injury, infection, arthritis, or tumor
If you look at someone’s back, you’ll see that the spine runs straight down the middle. When a person has scoliosis, their backbone curves to the side. The angle of the curve may be small, large or somewhere in between. But anything that measures more than 10 degrees is considered scoliosis. Doctors may use the letters “C” and “S” to describe the curve of the backbone. You probably don’t look directly at too many spines, but what you might notice about someone with scoliosis is the way they stand. They may lean a little or have shoulders or hips that look uneven.
In structural scoliosis, the curve of the spine is rigid and can’t be reversed. Causes include:
Congenital scoliosis begins as a baby’s back develops before birth. Problems with the tiny bones in the back, called vertebrae, can cause the spine to curve. The vertebrae may be incomplete or fail to divide properly. Doctors may detect this condition when the child is born. Or, they may not find it until the teen years.
Our Neuromuscular Center at Children’s Orthopaedic Clinic brings together a team of specialists from Neurology, Orthopedic Surgery, Physical Therapy, each of whom is experienced in caring for children with neuromuscular disorders. We work together to develop a treatment plan that meets your child’s unique needs and maximizes his quality of life.
The specialists in our center are experienced with the following disorders, as well as many others:
One of the most common symptoms of cerebral palsy is muscle stiffness and resulting spastic movements. Children living with this condition often struggle with their movements to varying degrees, and may even experience pain with these spastic movements. There are many different treatment options, but no cure for the muscle difficulties of CP. A treatment that can help many children by reducing spasticity is an injection of botulinum toxin A, This is a toxic substance that is created by bacteria, and which can be used medically in a way that is safe. There are some risks, but for a child for whom spastic movements cause difficulty moving, discomfort, and pain, it can provide significant relief. Some of the benefits that these children may see from injections include better range of motion, better positions of limbs and joints, fewer spastic movements, less pain, and a better walking gait. The relief it provides also means that surgery to correct muscle and joint problems may be delayed until the child is older and there are fewer risks.
There are times when surgery may be considered to improve ambulation, correct or prevent debilitating deformities, improve functioning levels, control pain, enhance appearance, or improve caregiver functions. For those with Cerebral Palsy, orthopedic surgeries are common, but they're not the only types of surgery that may be required in the life of a person who has Cerebral Palsy. When surgery is warranted, physicians want to minimize physical impairments and movement barriers as much as possible. The goal of orthopedic surgery is to create the ideal functional use of extremities while improving the individual’s ambulation with or without adaptive equipment.
Some goals of orthopedic surgery include:
While orthopedic reasons for surgery can be numerous, some opt for surgery to improve functionality and use it to address feeding difficulties, bowel and bladder challenges, ensure joint stability, correct spinal curvatures, or minimize drooling, for example. Some may wish to decrease chronic pain levels. Others may elect surgery for appearance, hygiene or caregiver reasons. This may involve improvements in gait, standing, bracing, aligning bite, or improving the appearance of a smile.
Gait analysis for cerebral palsy evaluates the movements of the lower body while walking.
For a person with cerebral palsy, gait analysis can be used to: