Identifying Orthopedic Problems in Children

Introduction

When orthopedic conditions are considered, people think orthopedic conditions develop with age, like arthritis and osteoporosis or any injury that causes hip, knee, and back pain. However, not all the conditions related to orthopedics occur only in later life. In some cases, young children are also exposed to pain caused due to orthopedic conditions. Sometimes, orthopedic conditions seen in children can impact their growth and development. Orthopedic conditions are very commonly seen in children. These conditions can be developmental, congenital, or acquired. There are many causes of orthopedic conditions in children, such as infection, neuromuscular, nutritional, psychogenic, or neoplastic origin. This article shows an overview of different orthopedic conditions in children.

What Are the Orthopedic Conditions Seen in Children Related to Feet?

• Metatarsus Adductus: This is a congenital condition where the forefoot is adducted and supinated. This condition can be treated using cast, splint, and manipulation. Surgery will be required only if the treatment is not over by the age of four.

• Calcaneovalgus Foot: This occurs in children with hyper-dorsiflexion of the foot. The abduction of the forefoot characterizes this condition. This condition will be managed within a few months; in some cases, it will get better once the child starts to stand independently.

• Planovalgus Deformity: This is one common condition that can affect cerebral palsy. The longitudinal arch of the foot will be very flat. This condition can be corrected with calcaneal lengthening. In severe cases, surgery will not be helpful due to an increased relapse rate.

• Talipes Equinovarus: This condition is a combination of abnormalities in the foot's tibia, fibula, and bone. This condition is also called clubfoot. This condition can be treated with casting, manipulation, and splinting.

• Pes Cavus: This condition causes high arches that do not flatten with weight bearing. Depending on the severity, physical therapy or surgery can help.

What Are the Orthopedic Abnormalities Seen in Children Related to the Toe?

• Curly Toe: This condition involves the fourth and fifth toes, which are usually inherited, asymptomatic, and bilateral. The age of three or four will resolve this condition.

• Overlapping Fifth Toe: This condition overrides the fourth toe and results in pain. This condition can be treated with surgery.

• Polydactyly: This is one common deformity seen in the foot, which can vary in severity by involving soft tissue duplication to skeletal abnormalities. One common abnormality is the presence of a fifth toe. This condition is usually treated with surgery.

• Web Toe: No treatment is required, but a thorough review is done to rule out other deformities.

• Mallet’s Toes: This condition is caused by flexion deformity. Surgery will be required only if the condition shows any symptoms.

• Ingrowing Toenail: This is a condition where the toenail starts growing inside the surrounding soft tissues. The treatment involves conservative management with antibiotics and various surgical procedures.

What Are the Orthopedic Abnormalities Seen in Children Related to the Leg?

• Internal Femoral Torsion: It is a condition that causes in-toeing in children due to abnormal sitting positions. This condition resolves independently, or physiotherapy or surgery will be required.

• Internal Tibial Torsion: This is a common cause of in-toeing in children more than the age of older than two years. This condition subsides when the child starts to walk.

• External Tibial Torsion: This condition is related to calcaneovalgus and subsides while the child starts to walk.

• Bow Leg: This occurs due to a tight posterior hip capsule. This condition resolves by the age of two.

• Leg Length Discrepancy: This condition is caused by growth asymmetry and can be corrected through physiotherapy or by correcting the muscular imbalance.

What Are the Orthopedic Abnormalities Seen in Children Related to the Hip?

• Developmental Dysplasia: A combination of disorders affecting the femur, hips, and the acetabulum. Early diagnosis prevents morbidity.

• Osteomyelitis: This condition is caused by Staph infection. It is treated through aspiration, arthroscopy, drainage, and debridement.

• Perthes’ Disease: This condition is an avascular necrosis caused in the femoral head. It is treated initially through blood tests, bracing, and analgesia. Surgery to redirect the femoral head may be required sometimes.

What Are the Other Regions That Are Affected by Orthopedic Problems?

The parts that get affected by orthopedic problems are

• Spine.

• Knee.

• Neck.

• Shoulder.

• Elbow.

• Wrist.

• Hand and fingers.

What Is the Importance of Early Diagnosis of Orthopedic Condition Children?

• Growth and Development: Diagnosing orthopedic conditions early can help promote proper growth and development.

• Preventing Complications: A timely diagnosis can prevent complications caused by these conditions, like joint deformities and functional limitations when left untreated.

• Reduction of Long-Term Impact: Early diagnosis and treatment can result in effective outcomes by reducing the impact of orthopedic problems on a child's regular life and future range of motion.

How Can Orthopedic Conditions in Children Be Treated?

• Regular Check-ups: Regular check-ups need to be scheduled to see the growth and development of the child—any concerns regarding the child's health need to be discussed with the doctor.

• Educate the Caregivers: The caregivers, educators, and school health professionals must be educated about orthopedic conditions. Early detection can occur anywhere, even at school.

• Encourage Physical Activity: Age-related physical activity, which helps to support bone health and the child's well-being, needs to be encouraged.

• Specialist Consultation: If any signs of orthopedic condition are noticed or any feedback from caregivers, immediate consultation with the specialist must be done for a comprehensive evaluation.

• Compliance With Treatment Plan: The treatment plan needs to be followed properly including physical therapy, surgical interventions, bracing, etc, to get good results.

Diagnosing and treating orthopedic conditions in young children is a collaborative effort of educators, caregivers, and health professionals. Children can develop strong bones and joints by promoting awareness and getting timely medical help.

Conclusion

An orthopedic condition that involves the bone and joint is common among elderly people but also affects young individuals and can be developmental, congenital, or acquired. Such orthopedic conditions in children need to be diagnosed and treated immediately, as they can impact the growth and development of the child. Depending on the severity, these conditions can be treated through physical therapy or surgeries.