Paediatric Orthopaedic Problem Management

Pediatric orthopedic problem management involves the diagnosis, treatment, and management of musculoskeletal conditions and injuries in children. These conditions can range from congenital abnormalities to developmental disorders and traumatic injuries. Here are some common pediatric orthopedic problems and their management approaches:

Developmental Dysplasia of the Hip (DDH):

• Pavlik Harness: This is a non-surgical treatment for infants with mild to moderate hip dysplasia. It involves the use of a special harness that helps to maintain the hip joint in a stable position.
• Closed Reduction and Spica Casting: In more severe cases, where the hip is dislocated, a closed reduction (manually repositioning the hip) may be followed by the application of a spica cast to hold the hip in the corrected position.
• Surgical Interventions: If non-surgical methods are ineffective, surgical procedures like open reduction and pelvic osteotomy may be considered.

Clubfoot (Congenital Talipes Equinovarus):

• Ponseti Method: The Ponseti method involves gentle manipulation and casting of the foot to gradually correct the deformity. It is often combined with Achilles tendon lengthening and the use of foot abduction braces.
• Surgical Interventions: In some cases, surgical procedures may be required to correct persistent or severe clubfoot deformities.

Limb Length Discrepancy:

• Observation: In some cases, minor differences in limb length may not require intervention and can be monitored over time.
• Epiphysiodesis: This procedure involves surgically stopping the growth of the longer limb by using techniques like the placement of staples or screws across the growth plate.
• Limb Lengthening: In more significant limb length discrepancies, limb lengthening techniques may be employed. This can be achieved through external fixators or internal lengthening devices.

Scoliosis:

• Observation: Mild cases of scoliosis may only require regular monitoring to track the progression of the curvature.
• Bracing: For moderate cases, bracing may be recommended to prevent further progression of the curvature and provide support.
• Surgery: Severe cases of scoliosis or those that progress rapidly may require surgical intervention. Spinal fusion with instrumentation is commonly performed to correct the curvature and stabilize the spine.

Fractures and Sports Injuries:

• Casts and Splints: Immobilization with casts or splints is often used to treat fractures in children, allowing the bones to heal properly.
• Closed Reduction: In cases where the fracture is displaced, a closed reduction may be performed to realign the bones without surgery.
• Surgical Interventions: In certain complex fractures or injuries that involve joint instability, surgical procedures such as open reduction and internal fixation may be necessary.