Definitions
Orthopaedics: Branch of surgery concerned with the skeletal system (ortho- [straight] + paes [child] = straightening the child. Varus deformity: the inward angulation of the distal segment of a bone or joint. Valgum deformity: the outward angulation of the distal segment of a bone or joint.
Orthotics: specialty concerned with the design, manufacture and application of orthoses which are devices that support or correct the function of a limb or the torso e.g. spinal brace. Prosthesis: an artificial device that replaces a missing part e.g. artificial limb.
Key Points
- Multidisciplinary approach is essential in the management of childhood orthopaedics.
- Cerebral palsy is the leading cause of childhood disability affecting function and development and a major social, medical and educational problem.
- DDH (CDH) a very serious condition if not diagnosed and treated early.
- Slipped capital femoral epiphysis is uncommon but requires emergency surgery to stabilize hip joint.
Classification
General Abnormalities
- Cerebral palsy: damage to the brain at birth leading to muscle weakness, spacticity, loss of voluntary control, deformity, seizures and intellectual impairment (40%). Rx:multidisciplinary approach: speech therapy, muscle training, splinting ± botulinum toxin, surgery to tendons, bone, nerves.
- Achondroplasia: dwarfing because of poor epiphyseal growth. Normal trunk and head.
- Osteochondroma: bony exostoses on shaft of long bone. No treatment required.
- Dyschondroplasia: cartilaginous cysts in bone (enchondroma) – thickening and shortening.
- Rare abnormalities:
osteogenesis imperfecta: collagen deficiency causing fragile bones – fractures, blue sclera
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