WhatsAppBone and Joint Health During Growth
Pediatric Orthopedics is the pediatric orthopedic specialty unit that carries out the diagnosis, conservative treatment and surgical management of bone, joint, muscle and tendon disorders from the newborn period to the end of adolescence. Because the growing skeleton has biological and biomechanical characteristics that differ from adult anatomy, diagnostic and treatment approaches are planned so as to preserve growth potential. Across a wide spectrum, from hip ultrasonography to surgical techniques that protect the growth plate, the Academic Hospital Pediatric Orthopedics Department brings children together with the most appropriate treatment method.
Contents
What Is Pediatric Orthopedics?
Pediatric orthopedics is the pediatric orthopedic specialty in which disorders of the bones, joints, muscles and connective tissue are assessed and treated throughout the period from birth until skeletal maturity is complete. The child's skeleton has a dynamic structure because of its developing growth plates; for this reason, the healing rate of fractures, the capacity of deformities to correct themselves spontaneously and the timing of surgery differ markedly from those in adults. Our department manages conditions that require specific experience in both diagnosis and treatment, such as developmental dysplasia of the hip, congenital foot deformities, scoliosis, Perthes disease and fractures involving the growth plate. Treatment decisions are made by anticipating the direction in which growth will continue, so that long-term functional outcomes are secured.
Which Diseases and Conditions Are Treated?
- Developmental dysplasia of the hip (DDH): Abnormal development of the hip joint from birth to early childhood; ultrasonography is used for diagnosis, and the Pavlik harness or surgical methods for treatment
- Congenital clubfoot (pes equinovarus): Serial casting with the Ponseti method and minimal surgical intervention when necessary
- Scoliosis: Curvature of the spine; adolescent idiopathic scoliosis, early-onset scoliosis and neuromuscular scoliosis
- Perthes disease (Legg-Calvé-Perthes): Bone necrosis caused by a temporary disruption of blood flow to the femoral head; conservative or surgical management depending on age
- Slipped capital femoral epiphysis (SCFE): Urgent surgical treatment of the condition in which the femoral head slips at the growth plate during adolescence
- Growth plate (physeal) fractures: Childhood fractures that require different assessment and treatment from adult fractures; a careful approach to prevent damage to the growth plate
- Leg length discrepancy: Conservative and surgical management of length asymmetry due to congenital or acquired causes
- Gait disorders and flat feet: Distinguishing physiological from pathological findings; investigating the causes of toe walking, in-toeing and limping
- Orthopedic problems associated with cerebral palsy: Surgical and orthotic management of spastic hip dislocation, knee flexion contracture and gait problems
- Bone infections in children (osteomyelitis and septic arthritis): Require urgent diagnosis and treatment; surgical drainage and long-term antibiotic therapy
- Sports injuries in children: Avulsion fractures, apophysitis (Osgood-Schlatter disease) and overuse injuries that place excessive load on the growth plate
- Bone tumors and tumor-like lesions: Monitoring and treatment of simple bone cysts, aneurysmal bone cysts and benign tumoral lesions
When Should You Consult Us?
If you notice any of the following in your child, it is advisable to consult the Pediatric Orthopedics Department.
- Limping, marked difficulty when running or a sudden change in the way your child walks
- Pain in the hip, knee or ankle, especially night pain or pain that increases with activity
- Curvature of the back or a noticeable difference in shoulder height
- Foot deformity: a clubfoot appearance in a newborn, toe walking or excessively flat feet
- Swelling, deformity or painful restriction of movement after a fall, a knock or an injury
- A clicking sound during hip examination or a sense that the legs are not of equal length; in babies, noticing during diaper changes that one leg opens less than the other
- Joint swelling accompanied by fever and inability to bear weight on the leg: requires urgent evaluation for septic arthritis
- Suspicion that a fracture sustained in childhood has healed incorrectly
Diagnostic Methods
In pediatric orthopedics, diagnosis is made using age-specific assessment tools.
| Method | What it is used for |
|---|---|
| Includes neuromuscular assessment, measurement of joint range of motion, the Adams forward bend test for scoliosis and hip examination (Ortolani and Barlow maneuvers) | |
| The preferred method for diagnosing DDH in the newborn and infant period, based on the Graf classification; involves no radiation | |
| Interpretation of radiographs that assess the growth plates according to the child's age and stage of growth; imaging of fractures, dysplasia and deformities | |
| Used to assess articular cartilage, growth plate damage, muscle tissue and bone marrow involvement | |
| Three-dimensional imaging of bone structure in complex fractures and in deformities that require surgical planning | |
| Objective assessment of cerebral palsy, central nervous system involvement or complex gait disorders | |
| Investigation of infection (CRP, erythrocyte sedimentation rate, white blood cell count, joint fluid culture) or metabolic bone disease (vitamin D, calcium, phosphorus, ALP) | |
| Estimation of growth potential using the Risser stage and bone age; a key tool in predicting the progression of scoliosis |
Treatment Approaches
Treatment is determined as conservative or surgical according to the type of condition, the child's age and growth potential.
| Treatment | Scope and application |
|---|---|
| In conditions such as mild gait disorders, small leg length discrepancies and physiological flat feet, the child is monitored throughout growth in anticipation of spontaneous correction | |
| The gold standard in the treatment of congenital clubfoot; the foot is brought into its natural position with weekly cast changes, after which an Achilles tenotomy may be performed. | |
| In the early treatment of DDH, they hold the hip joint in the correct position so that it can develop | |
| The primary treatment used in growth plate fractures, in closed reduction of DDH and in certain types of fracture | |
| Brace treatment worn for long hours during the day to prevent progression of the curve in children with scoliosis whose Cobb angle is between twenty-five and forty-five degrees and who are still growing | |
| Conservative management supported by muscle strengthening, flexibility exercises and posture training | |
| Fixation, osteotomy and deformity correction performed with minimal damage to the epiphysis; requires protocols that differ from adult surgical techniques | |
| Spinal fusion or growth-guiding implant systems (growing rods) for progressive curves greater than forty-five degrees | |
| Improvement of functional walking through multiple muscle-tendon lengthenings in a single session (SEMLS: Single Event Multilevel Surgery) and hip capsulotomy | |
| A comprehensive recovery program after surgery, carried out with physical therapy, occupational therapy and, when needed, a child development specialist |
Appointments for the Academic Hospital Pediatric Orthopedics Department: 444 0 353
Book an AppointmentPediatric Orthopedics at Academic Hospital
The Academic Hospital Pediatric Orthopedics Department plans the assessment and treatment of bone, joint and muscle problems from the newborn period to the end of adolescence with the child's growth in mind. During diagnosis and treatment, the department works together with the following departments when needed:
- Orthopaedics and Traumatology: transition to adult orthopedic follow-up for young people who have reached skeletal maturity, and trauma surgery
- Scoliosis and Spine Center: joint planning of brace and surgical treatment for progressive spinal curves
- Pediatrics: newborn hip examination, growth monitoring and initial assessment
- Pediatric Neurology: shared follow-up of orthopedic problems related to cerebral palsy and neuromuscular diseases
- Physical Medicine and Rehabilitation: rehabilitation programs during conservative treatment and after surgery
- Pediatric Rheumatology: distinguishing rheumatological causes of joint swelling and limping
- Radiology: X-ray, MRI and CT examinations
Frequently Asked Questions
References
The general information given on this page about childhood bone and joint conditions, diagnostic methods and treatment approaches is supported by the reliable health sources listed below.
- Pediatric Orthopaedic Society of North America (POSNA), "Study Guide", posna.org
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo, "Developmental Dislocation of the Hip", orthoinfo.aaos.org
- NHS, "Scoliosis: Diagnosis and Treatment", nhs.uk
- Dobbs MB, Gurnett CA, "Genetics of Clubfoot", J Pediatr Orthop B. 2012, pubmed.ncbi.nlm.nih.gov
The information on this page is for informational purposes only; it does not replace medical examination, diagnosis or treatment. Please consult a healthcare institution regarding your complaints.
