Pediatric Orthopaedic Conditions

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The specialty that treats genetic-related or acquired bone diseases and bone defects that develop during gestation is called pediatric orthopaedics.

Children born with congenital bone diseases will require the expertise of a pediatric specialist. Likewise, developmental and musculoskeletal disorders will also require help from a pediatric orthopaedics specialist.

While some conditions correct themselves sans treatment, others can become severe when left unattended.

Below are some of the most common pediatric orthopaedic disorders parents need to look out for:

Toes

Curly toes – this condition usually affects the fourth and the fifth toes. Oftentimes inherited, curly toes do not manifest any symptoms in most cases. At least 25 to 50 percent of the cases are resolved by the time the child turns 3 or 4 years old. Otherwise, surgery will be needed.

Polydactyly – this disorder is considered one of the most common and severity can vary from minor soft tissue duplication down to severe skeletal abnormalities. Surgical removal is often the likely treatment recourse for polydactyly.

Ingrowing toenail – when the nail’s edge grows into the soft tissue that surrounds it, an ingrown toenail develops. Management of the condition can range from noninvasive treatments (antibiotics and warm soaks) to surgery.

Hammer toe – this condition often affects the second toe and may require surgery if painful.

Legs

Internal tibial torsion – this condition is the most prevalent cause of in-toeing in children aged 2 years and below. Fortunately, the condition is often resolved once the child starts walking.

Bow-legged (genu varum) – the condition is often attributed to a tightened posterior hip capsule. When it does not get resolved by the time the child turns 2, osteotomy might be recommended.

Knock-kneed (genu valgum) – the condition is often benign and gets corrected when the child turns 8 years old. However, if the condition persists until the child turns 10 years old, surgery might be recommended.

Internal femoral torsion – this condition is known as the most prevalent cause of in-toeing in children aged 2 and above. Correcting an abnormal sitting position would be enough to treat the condition.

Foot

Talipes equinovarus – diverse abnormalities of the fibula, tibia, and the bones found in the foot form a composite disorder known as club foot. Treatment options can include casting, manipulation, splinting, and surgery.

Pes cavus – the condition is characterized by a high arch that does not flatten even with weight-bearing. Treatment options can include orthotics, physical therapy, and surgery. Chosen treatment will often depend on the condition’s severity.

Planovalgus deformity – this condition is associated with cerebral palsy. In non-ambulatory children (with severe deformity) relapse rate is high and surgery might not offer much help. In ambulatory children, mild to moderate deformities are often treated through calcaneal lengthening.

Hip

Perthes’ disease – this disorder is characterized by the idiopathic avascular necrosis of the femoral head. Interventions will often include bracing, analgesia, and bed rest. Femural varus osteotomy (operation to redirect the femoral head’s ball) is required in some cases.

Transient monoarticular synovitis – this condition is known as one of the common causes of limping and often develops after a respiratory infection. Treatment options can include NSAIDs, physiotherapy, and rest.

Septic arthritis – this condition is often attributed to Staphylococcus aureus. Treatment options include arthroscopy, drainage and debridement (with antibiotic cover), and emergency aspiration.

Developmental dysplasia – this spectrum of disorders affects the hips, proximal femur, and the acetabulum. Early detection and treatment can help prevent long-term morbidity.

Knee

Baker’s cyst (Popliteal cyst) – this synovial cyst will often respond to conservative treatments. However, arthroscopy might be required when there is an underlying internal derangement in the knee.

Patellar subluxation and dislocation – this congenital disorder is typically treated through immobilization. However, if condition becomes chronic, surgery might be recommended.

Discoid lateral meniscus – this congenital malformation may require arthroscopic repair when it becomes troublesome.

Osgood-Schlatter disease (Tibial apophysitis) – this condition will often respond to conservative treatments like bracing, orthotics, activity modification, and physical treatment.

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