Paediatric Orthopaedics is a specialised service which provides surgical and non-surgical treatment for children affected with congenital, developmental and acquired musculoskeletal conditions. Children are growing and developing physically, mentally, and emotionally so they need care that not only addresses their current needs but also protects their future health and well-being.
Children need special care as their anatomic and physiological development differs from that of adults. Orthopaedic conditions, in children, that are related to birth and congenital defects require ongoing treatment and care from birth into adulthood.
Congenital and hereditary causes:
An infant’s foot is turned inward and downward, making it impossible to walk. Congenital limb defect - an arm or leg doesn’t form normally as a baby grows in the uterus. Limb length differences – when both limbs are not of equal length and may cause the child to limp.
Developmental dysplasia of the hip - when the hip ball and socket don’t fit together properly, it increases the risk of hip instability, Becker muscular dystrophy (BMD) which causes weakness of skeletal muscles, breathing muscles, and the heart muscle. Cerebral palsy – a neurological disorder that affects body movement, muscle control, coordination, reflexes, posture, and balance.
Neuromuscular diseases affect the function of muscles due to problems with the nerves and muscles in the body.
Growth related causes:
Kyphosis is a deformity of the backbone. It’s when the bones of the spine in the upper back curve outward more than they should. Perthes disease is a rare hip condition that affects children where the ball-shaped top of a child’s thighbone breaks down and re-forms.
Nursemaid’s elbow is a type of elbow injury. It’s when a forearm bone (radius) slips out of place from where it normally attaches to the elbow joint. Scoliosis is an abnormal curvature of the spine toward either the left or the right side of the body. Metatarsus adductus (the foot turns inward), Tibial torsion (the shinbone turns inward).
Femoral anteversion (the thighbone turns inward), in which the child may look pigeon-toed. Osteosarcoma is a bone cancer that occurs mostly in children and adolescents. This tumour develops around the hip, shoulder, or knee and spreads rapidly to other parts of the body.
Inflammatory and infectious causes:
Juvenile rheumatoid arthritis- An auto-immune disease in which the immune system, begins to attack healthy cells and tissues instead of fighting off harmful bacteria or viruses resulting in inflammation, redness, heat and pain. Osteomyelitis is an inflammation or swelling of bone tissue. It’s most often caused by a bacterial infection of the blood. Septic arthritis is an infection in the joint (synovial) fluid and joint tissues.
A fracture is a partial or complete break in the bone when more force is applied to the bone than the bone can absorb. Overuse and sports injuries can affect nearly any part of the body or any portion of the musculoskeletal system, including the bones, joints, nerves, muscles, tendons, ligaments or cartilage.
Dislocation is a joint injury that occurs when the ends of two connected bones come apart. A sprain is an injury caused by sudden stretching, twisting, or tearing of a ligament while a strain is caused by pulling or tearing of a muscle or a tendon. Growth plate fracture affects the layer of growing tissue near the ends of a child's bones.
Children may be at a higher risk of orthopaedic problems due to:
Signs & Symptoms:
Some of the signs and symptoms among children who need orthopaedic care include:
Paediatric orthopaedic specialists at Medcare will diagnose orthopaedic problems among children based on:
From the simplest to the most complex orthopaedic treatment for children consult our paediatric orthopaedic specialists in Dubai or Sharjah by visiting Medcare. A paediatric orthopaedic doctor has specialized training in management of acute, chronic and congenital musculoskeletal conditions in children.
Treatment for any condition is always personalised based on your child’s age, development and size. Depending on which part of the body has a problem, the paediatric orthopaedic doctor will recommend:
Some common conditions seen in children and their treatment:
Clubfoot is treated by the Ponseti method, which uses gentle stretching and casting to gradually correct the deformity. Scoliosis (mostly idiopathic) is an abnormal curvature of the spine toward either the left or the right side of the body. It is usually treated with braces or a surgical procedure called "spinal fusion" that straightens the curve and then fuses the vertebrae together so that they heal into a single, solid bone. This will stop growth completely in the part of the spine affected by scoliosis.
Osteosarcoma is a bone cancer in which the tumour develops around the hip, shoulder, or knee, and the treatment for malignant tumors involves a combination of chemotherapy, radiation, and surgery.
A: You can share your concerns with the paediatric orthopaedic specialist and understand whether a surgery is necessary or not. The specialist will always consider non-surgical options first. However, open and compound fractures, displaced growth-plate fractures, as well as those that involve joint surface, typically heal better with surgery.Q: My baby was born with an extra little finger. Will she need surgery in the future?
A: Don’t worry yourself about this condition. An extra little finger often doesn’t affect how she uses her hand, and some people live with it. You may feel that it should be removed for cosmetic reasons. If the extra finger does not contain any bones, the removal is quite simple. The paediatric orthopaedic doctor at Medcare will advise you on the correct course of action.Q: My son has one leg longer than the other. Will he need surgery?
A: Leg length discrepancy (LLD) in a child is treated by considering the child’s final height and leg lengths. If the LLD is estimated to become over 2 cm, only then is treatment required. In some cases, an orthopaedic shoe is helpful in correcting the condition. Only in a few cases is surgery recommended for either the shorter or longer leg.Q: My daughter broke her arm, and the doctor tells me it’s a growth plate fracture. What does that mean?
A: Growth plates are thin cartilage plates at the end of children’s long bones. A growth plate fracture can affect the way the bone will grow. If not treated correctly, growth plate fracture could lead to a deformity. So do take the advice of the paediatric orthopaedic specialist at Medcare very seriously.