Pediatric orthopedics focus on providing surgical and non-surgical care for children affected by bone, muscle, and joint conditions.
Because the child’s human body is still in its developmental stages, pediatric orthopedic conditions are different from adult conditions and can sometimes be more complex. Because the bones, ligaments, and muscles are still developing in the child, management and treatment plans require additional consideration. One of the most significant differences in children is the presence of the growth plate in pediatric bones. The growth plate can be identified on Xray and is the area at the ends of bones that causes new bone formation.
There are a multitude of pediatric orthopedic conditions, some of which are quite common and others that are seen rarely. Kohler disease, for example, is a very rare bone disease in children. Scoliosis and clubfoot, however, are more common, with nearly 3 million new cases of scoliosis being diagnosed each year.
In what follows, we’ll be outlining and describing some of the noteworthy pediatric orthopedic conditions. We’ll also bring attention to the most common and effective general pediatric orthopedic treatments.
Types of Pediatric Orthopedic Conditions
There are several types of pediatric orthopedic conditions, some of which can also be seen in adults. Whether an inherent disorder or deformity, sport-related injury, or disease, pediatric orthopedic conditions range in prevalence and severity.
In some conditions, it’s apparent what has caused the issue, such as in a traumatic injury or sports injury. Yet, in other pediatric orthopedic conditions, it’s difficult to determine the exact cause, although in most cases, there are prominent theories.
These are some prominent pediatric orthopedic conditions:
- Club Foot
- Colles Fracture (Fracture Of The Wrist Radial Bone – Broken Wrist)
- Osgood-Schlatter’s Disease (Knee Pain and Swelling Due to Growth/Development)
- Hip Dysplasia
Clubfoot, one of the most common pediatric orthopedic conditions, can be familial or can occur as a part of another syndrome. The condition is characterized by the “in-toeing” of the foot. Most cases will resolve over time, although sometimes the surgical repair is necessary.
Colles fracture is the most common fracture of the wrist seen in children. For uncomplicated Colles fractures, casting is the treatment. In some cases, there is concern about growth restriction if the fracture is more complex, and these cases will need close supervision and treatment by an orthopedist who is experienced in pediatric care.
Osgood-Schlatter’s Disease is an inflammatory process in the cartilage of the tibia in the location of the tibial tuberosity. This is a common condition in adolescent athletes. There is usually pain and swelling in the area of the tibia just below the patella. The condition will usually resolve with rest and time.
Scoliosis is a curvature of the spine that can commonly occur in childhood. Based on certain criteria and measurements of specific angles of the spine, the patient may need an orthopedic evaluation. Management may include bracing or, in some cases, surgical treatment.
Hip dysplasia is a condition in which the infant hip joint has an abnormal formation and associated mechanical instability. This is found at birth, and the hip joint will have laxity on examination. The condition spontaneously improves in most cases, but it can also be associated with other medical syndromes. The condition should be closely monitored to ensure that resolution occurs.
Other sport-related pediatric orthopedic injuries include runner’s knee, tennis elbow, tears, sprains, and strains.
Common Pediatric Orthopedic Treatment Options
In more complex orthopedic conditions such as severe scoliosis, specialized orthopedic treatment in collaboration with physical and occupational therapy has been a very successful process. An ongoing regular evaluation by an orthopedist will determine if surgical management will be necessary, and decisions about surgical treatment can be made in a timely manner. Efforts are always directed toward the conservative management of pediatric orthopedic conditions, and the decision for surgery is made when there is no alternative.
If a child is living with a manageable orthopedic condition, however, they also have a comorbid health condition such as obesity, they will need to have help to make a change in lifestyle. They will need to focus on losing weight, increasing exercise and mobility, and improving their diet. These changes will have a drastic impact on overall health as well as management of the orthopedic condition. Parental assistance and co-management of this effort will be necessary for success.
Orthopedic conditions in children can be difficult for families to manage. Even more difficult is the decision to move forth with surgical treatment should the child require it.
In the case of pediatrics, some orthopedic conditions will improve throughout the developmental stage of a child’s life. In these circumstances, conservative management is optimal, yet continued follow-up with an orthopedist will lead to the best outcomes.
As a parent caring for a child with an orthopedic condition, it’s imperative to stay on top of the most recent literature about any orthopedic condition while also being proactive and attentive to ongoing regular follow-up visits.