From infancy to the teenage period each age group has its own important orthopedic “exclamation mark”, originating from the characteristics of the musculoskeletal system typical of the given age, which should be taken great care of. The pediatrician and also the parents must pay attention to the hip’s status and footing in infancy, foot problems at toddlers and smaller children, while during puberty they have to devote more attention to the backbone. Having examined the child in due time by the orthopedic specialist, in most cases the developing abnormalities could be well treated and cured, even completely.
Why does the after-birth orthopedic screening have great importance?
Have you known the following statistical data?
- children who were born in the spring term are more prone to hip underdevelopment
- this is a very important fact confirmed by the scientific literature of pediatric orthopedics
- as per gender statistics this inter-uterine underdevelopment defect is more common in girls (so far the exact cause of this abnormality has not been known. There is, however, a hypothesis that it is correlated with the X chromosome), so that’s why it is very important to detect the disease as early as possible, preferably within a few days or weeks after the baby’s birth
- in case of breech babies hip underdevelopment could also be diagnosed more frequently
Owing to the reasons mentioned above, orthopedic screening performed at the baby’s age of six weeks – complemented with the ultrasonic scan of the hip (see link) – has an utmost importance.
At our clinic an ultrasound equipment with excellent imaging capability is at the disposal of both our radiologist and orthopedic specialist. By completing the manual examination, the pediatric orthopedist could immediately recognize tight muscles which come back to the hip and affect the child’s later motion and walking as well. That is why it is important to provide an immediate help for the baby.
Prevent hip dislocation!
Let’s imagine that we put our fist into the opened hollow of our other hand and we cover it by our fingers. This is the way in which the so-called articular cavity holds the baby’s thighbone. If the articular cavity does not fasten well the thighbone namely it may slip out from it. Moreover if the cavity remains open, there is a high risk that – when the baby comes to get on his or her feet by passing the age of 8-10 months – a hip dislocation may develop as a consequence of the thighbone’s slipping out from the articular cavity. Unfortunately such cases could only be improved by operation. In the first part of the infancy the skeleton system could be forced to be formed so if we keep the baby in a natural, fetal posture for a few weeks the hip joint can be recuperated completely. To keep this posture we have to use a special swaddle keeping the baby’s hip in a correct and ergonomic position. In more serious cases a special device called Pavlik harness must be applied for this purpose. Application of these instruments does not cause any problem to the newborn since his or her legs’ posture is similar to that of inside the uterus.
Footing and other defects
It may happen that there is a deviation in the axis of the child’s sole meaning that foot turns in and takes a crescent shape or even curves inwards completely. There are also cases when the baby is born with a slight faulty neck posture or very rarely with a scoliosis of the spine. In most cases turned-in foot could be treated by simple motion or massage. If the deviation is more serious we could apply special boots and by passing the age of 6-8 weeks posture of the feet could be perfect. This short, two-month therapy will prevent a number of future musculoskeletal problems.
Consequences of smaller accidents
In early childhood smaller accidents like a fall in the playpen or a leg caught up in the bars of the bed may lead to a so-called greenstick fracture. In this situation the baby does not feel pain in the joints, consequently does not cry when he or she moves, just simply does not make certain motions which are unpleasant. It happens sometime that parents recognize that the child – already capable for even running – suddenly starts walking lame by this way sparing his or her leg instinctively. This situation requires an immediate check-up because different problems, ranging from a smaller inflammation to more serious defects like hidden injuries requiring prompt intervention, may be in the background. Lack of treatment or incorrect therapies may lead to long-term, harmful consequences.
Small children, school and puberty age
Small children (age of 3-5 years) may face foot problems. During school age (age 6-11 years), as a consequence of the children’s growth joint problems may emerge such as knee pain, heel pain. In puberty the main query is the appearance of spine problems and bad posture which in lack of attention may prevail throughout our children’s life.
More details about spine problems in puberty
Have you known that as per the specialists’ statistics:
- over the last 40 years children have grown taller and taller
- we have a much more sedentary lifestyle than before
- physical development of young teenagers is affected by inward, psychical aspects as well
- teenage poor posture problems are the basis of adulthood back and backbone pains, wear of the joints and more serious musculoskeletal diseases
- based on summaries of screenings – much to general consternation – about 50 % of the pubescents suffer from bad posture problems
half of the children in age groups between 12 and 18 years have minor or more serious bad posture abnormalities which necessarily need continuous treatment
What are the signs which the parents should pay attention to?
It is important to know that too much time elapses between the in-school screening examinations considering the condition of the quickly developing young organism.
That’s why we have to consult the orthopedic specialist in any case:
- if we recognize that our child could only carry comfortably the bag on one shoulder by arched back or in an unusual way
- if our child keeps his or her shoulders forward (rounded shoulders) or in an uneven position
- if he or she frequently holds his head to downward position
- if the child has a protuberating belly due to the increased spinal curvature at the waist
- if parents recognize a sideward spinal curvature or they notice a kyphosis (gibbosity)
- if the child suffers from back aches and/or low back pains
The specialist of pediatric orthopedics is the partner of the parents
In pediatric orthopedics more severe problems like spinal angulation or poor posture need much time to be treated. On long term these diseases cannot be cured by medication but it may happen that the pubescent child has to undergo physiotherapy or possibly wear a corset type spinal brace (assuring the linearity of the spine), which is not easy to accept for a sensitive young teenager. The orthopedic specialist keeps on supporting the adolescent and the family from the start of the whole course of the treatment till the teenager becomes an adult, by giving advice, offering therapies including physiotherapy, swimming and other methods for the elimination of bad posture. For the child, suffering from spinal or other orthopedic complaints, it is important that the specialist observes the whole period of his or her coming-of-age – that’s why the timing of the child’s first examination has great relevance.
Completing the long but successful therapies, the specialist of pediatric orthopedics has a mutual pleasure with the child and the parents since the care and paid attention will support the healthy adulthood.