Orthopedic diseases and treatment in children
What are the common orthopedic diseases in childhood? How are these orthopedic diseases treated? Here are the details… “Orthopedic disorders, which are common in infancy and after, can be divided into pre-walking and post-walking periods,” said Orthopedics Specialist and Traumatology Specialist Assoc. Dr. Salih Carpenter talked about the problems encountered in infancy. Introversion of the foot: One of the most common postpartum problems is the ‘metatarsus adductus’ disorder, which is seen in approximately one in a hundred births. In this disorder, which can be summarized as introversion of the front of the foot, the shape of the foot is likened to a bean.
Those who are flexible have a 90 percent potential to recover spontaneously, but still stretching exercises can be done by the family in the opposite direction. In some cases, the plastering method may be a choice to accelerate the healing. Rarely, surgery may be considered in children older than 3 years of age who do not respond to previous treatments. Bending hips, knees and elbows: It is physiological, that is, normal for newborns to have slight bends in the hip, knee and elbow joints. The absence of these may suggest that there is a problem.
Bends, ie flexion contractures, improve with age. In fact, the bent position of the hip is a necessary position for the normal development of the hip joint in babies. Swaddling, which was widely used in the past but abandoned today, is an example of a wrong practice, trying to straighten the baby’s hips and knees and bring their legs together, which paves the way for developmental hip dysplasia and increases the risk. Hip dislocation: ‘developmental hip dysplasia’ (popularly known as congenital hip dislocation) is seen at an average rate of six per thousand in Turkey. In order to detect developmental dysplasia of the hip in the early period, all babies with risk factors should be screened with a radiation-free method called hip ultrasound.
This examination is carried out by orthopedists and radiologists who have received relevant training.
Risk factors are as follows: The baby is inverted in the mother’s womb (breech presentation), the baby has a congenital muscle-induced neck curvature in the baby’s neck, there is a hip dislocation in the family, the baby is the first baby and the gender is a girl. In addition to the hip examination of the baby to be performed by a pediatric orthopedist, if there are findings in the direction of developmental hip dysplasia as a result of hip ultrasound, treatment should be started without delay. In the treatment, a flexible device called “Pavlik bandage” is used, which is attached to the baby’s legs and body, allowing the baby to move in certain positions. Due to the nature of this bandage and the negative consequences it may cause, the bandage should be applied by an orthopedist physician, and the family should be well informed and followed closely. Clubfoot: Another common ailment in infancy is pes equinovarus, also known as clubfoot.
The disease is called ‘clubfoot’ in English because the shape of the foot and leg is similar to that of a golf club.
This introversion in the foot, which occurs in the womb for an unknown reason, can be noticed in prenatal ultrasounds. Although this discomfort in the foot seems similar to the ‘metatarsus adductus’, it is much harder than it, and the problem is not only in the front of the foot, but in the whole foot. The “Ponseti method” has become a standard in the treatment of this problem all over the world. It is possible to obtain a successful result by using manipulation and casting techniques suitable for the Ponseti method in the treatment that will begin around the first 10 days to 2 weeks after birth.
Neck curvature: One of the most common conditions in babies is congenital muscle-induced neck curvature (congenital muscular torticollis). This is caused by an unexplained shortening of a muscle that runs from the upper middle part of the rib cage to the back of the ear. The breech and difficult delivery of the baby are among the risk factors.
When such a situation is suspected, a physician should be consulted, and treatment should be started immediately with appropriate stretching exercises and massage applications.
This condition usually tends to resolve spontaneously. Note: Some other less common diseases related to infancy are not included here. After the baby’s examination by the family physician, it may be necessary to refer the baby to an orthopedic and traumatology specialist, if deemed necessary.
