Pediatric Orthopedic Surgeon is the specialist who deals with all problems which affect the bones, joints, ligaments, and muscles of the growing child. He or she is best equipped to understand the unique requirements of care which are necessary to deal with the musculoskeletal problems of a growing child. This unique expertise in the medical and surgical care of children is acquired from advanced training and experience in practice.
The medical care of a child is different from that of an adult, and no one knows this as well as a Pediatrician (Child specialist). Similarly, the Orthopedic care of a child is different from that of an adult.
Nothing can be truer than the common saying “A child is not just a little adult” when dealing with childhood bone and joint problems.
The anatomic, physiological, and metabolic features of a growing skeletal system are different from those of a mature skeletal system, and by extension, the problems which affect children’s bones and joints are different as well. Indeed, some pathology is unique to the growing child and adolescent. A general orthopedic surgeon may not have adequate expertise or experience in the optimal management of some of these unique pathologies.
This makes Pediatric Orthopedic practice (Children’s Orthopedics) a highly specialized and niche service, which provides surgical and non-surgical treatment for various musculoskeletal problems affecting children.
Clubfoot describes as a range of foot abnormalities usually present at the time of birth in which your baby’s foot got twisted out of shape or position. In clubfoot, the tissues connecting the muscles to the bone are shorter than usual. Clubfoot is a fairly common birth deficiency and is usually an isolated problem for an otherwise healthy newborn.
Clubfoot can be seen as mild or severe. Almost half of the children who have clubfoot have it in both feet. If your child has clubfoot, it will make it harder for the child to walk normally or even stand in severer cases, so doctors generally recommend starting treatment soon after birth.
Doctors can treat clubfoot without surgery in most cases but in severe cases, surgery is required with the basic treatment.
The cause of clubfoot is unknown (idiopathic), but it may be a combination of genetics and environment.
The exact cause of clubfoot is still not known (Idiopathic). Other reasons for this could be genetic, the position of the baby in the mother’s womb, neuromuscular disorders, etc. The parents must get the child screened immediately to assess his health condition and identify the exact cause of the congenital deformity. There is no correlation of clubfoot in any type of deficiency, deformity, and other ritual myths like “GRAHAN”.
The deformity is obvious and apparent and can be diagnosed immediately after birth.
• The top of the foot is usually twisted downward and inward, increasing the arch and turning the heel inward.
• The foot may be turned so severely that it actually looks as if it’s upside down.
• The affected leg or foot may be slightly shorter.
• The calf muscles in the affected leg are usually underdeveloped.
Despite its look, clubfoot itself doesn’t cause any discomfort or pain at the time of birth.
The most important symptom of clubfeet is the foot looking deformed and twisted like the club of the golf stick. But the child will experience discomfort and find it difficult to walk if clubfoot is not treated properly and timely. The child may find it difficult to wear shoes and participate in physical activities. Sometimes foot size of the affected side appears smaller than the normal side.
Clubfoot can be diagnosed even before a baby is born by Ultrasound. Or after birth by observing the appearance and movement of the baby’s feet and legs your doctor can advise you on the most appropriate treatment or refer you to a doctor who specializes in child bone and muscle treatment (pediatric orthopaedist).
While it is true that the healing and remodeling capacity of children following injuries is greater than adults, there are certain key distinctions.
For example, growth plate injuries (physical injuries) are unique to growing children, and if undetected or inappropriately treated, these may heal with permanent sequelae such as deformity or length discrepancy. Similarly, developmental problems such as hip dysplasia need to be screened for in the “at risk’ babies, so that they can be identified and treated early with simple measures rather than complex interventions at a later date which will have an adverse impact on the eventual outcome.
Pathologies unique to the growing child such as Perthes’ disease, Developmental coxa vara, Slipped Upper Femoral Epiphysis, Idiopathic scoliosis need a clear understanding of the natural history of the condition, in order to identify any potential adverse clinical or radiological changes which may need early and proactive intervention.
Modern anesthetic techniques and practices are extremely safe and have greatly reduced the incidence of adverse events. Your child will be evaluated by an anesthetist prior to the surgical procedure, and this evaluation may involve blood investigations if necessary. Make sure you inform the anesthetist about any background medical problems that your child may have including ongoing medications.
Surgery for a child can be extremely stressful for the parent. Children are influenced by the reaction of their parents, and it helps a child if the parents present a calm and positive demeanor.
Make sure you discuss all your doubts and anxieties with your surgeon and anesthetist, however trivial they may appear to be.
While all children go through a certain consistency in the pattern of growth and development, there are subtle variations in each child. Making a distinction between what is abnormal and what is just a growth variation needs knowledge, clinical skill, and experience.
A substantial proportion of office Pediatric Orthopedic practice involves sifting developmental pathologies from such growth variations and treating them appropriately.
Clubfoot treatment involves serial plaster casts followed by a minor surgical procedure called a tenotomy.
It’s cost-effective and very good results can be expected with treatment.
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