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Paediatric Orthopaedics

Overview

What is Paediatric Orthopaedics?

Paediatric orthopaedics is a subspecialty of orthopaedics that diagnoses, treats and manages musculoskeletal conditions in children, from newborns through to adolescents. A child's growing bones, joints, and muscles are fundamentally different from those of an adult which means they require specialised knowledge and a unique approach to care.

A paediatric orthopaedic surgeon, who is trained to understand these complexities, takes into consideration how treatment will affect a child's future growth and development, not just the immediate injury or deformity. Paediatric orthopaedics is all encompassing. It treats and manages anything from congenital limb differences and growth plate injuries to scoliosis and sports-related trauma. In essence, it involves guiding a child's musculoskeletal system to mature as normally as possible, meaning its scope extends way beyond surgical skill on its own. Its main objective is to help growing children to live a normal life and can run, play and thrive without limitation.

Types of Paediatric Orthopaedic Conditions

Many conditions fall under paediatric orthopaedics making it broad. This reflects the unique challenges of a developing skeleton and all the conditions and issues that may arise with growth. Because of this, we manage congenital and developmental conditions present from birth or early childhood, and deal with issues for all ages. Clubfoot, developmental dysplasia of the hip (DDH) and limb length discrepancies are some of the conditions treated followed by neuromuscular disorders like cerebral palsy or spina bifida. Many conditions are known to affect muscle control and bone development, which makes treatment paramount.

To prevent growth disturbances, injuries require a different approach in children with growth plate fractures for instance, requiring careful management. Common childhood fractures are treated here at NMC and cater to sports injuries and overuse syndromes like Osgood-Schlatter disease. We are experts in spinal deformities which are a key focus of care. This includes scoliosis, which is the curvature of the spine, and kyphosis which because of their nature, often require long-term monitoring and timely intervention. All the strategies put together by our teams are tailored to respect the child's ongoing growth and individual experience.

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To safeguard a child's long-term musculoskeletal health, knowing when to seek specialist advice is crucial. Parents should consider a consultation with a paediatric orthopaedic surgeon near them if they notice persistent limping, complaints of joint or bone pain that doesn't resolve with rest. The same goes for obvious asymmetry in limb length or posture, which should also be tended to. Other signs like in-toeing or out-toeing gait beyond the toddler years, a hip that clicks or seems unstable or a curved spine when bending forward would also warrant an evaluation.

An assessment by a specialist becomes necessary for any fracture involving a growth plate or a severe sports injury. Concerns about a baby should be addressed very soon after birth, like hip stability or the shape of their feet, like in clubfoot. Any concern, big or small, about how a child's bones, joints or muscles are developing or functioning requires the expert opinion of a paediatric orthopaedic surgeon across Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain.

A gentle, thorough consultation that involves both the child and their parents to discuss history, symptoms and developmental milestones would be the first step taken. A careful physical examination is paramount used to assess gait, joint range of motion, limb alignment and muscle strength in a child-friendly manner. Our examination techniques reflect the unique needs of a child.

Imaging is used judiciously to complement all clinical findings with X-rays being the primary tool that give us specialised views to assess growth plates. Ultrasound is invaluable in diagnostics, helping us evaluate infant hips in DDH. In order for us to visualise soft tissues and cartilage without radiation in more complex spinal or joint conditions, an MRI scan may be necessary. The diagnostic process helps in building a complete picture of the condition within the context of the child's remaining growth which is essential for treatment planning.

  • Congenital Conditions: Clubfoot, Developmental Dysplasia of the Hip (DDH), Congenital limb deficiencies.
  • Spinal Deformities: Adolescent Idiopathic Scoliosis, Kyphosis, Scheuermann's disease.
  • Growth-Related & Bone Disorders: Limb length discrepancy, Blount's disease, Slipped Capital Femoral Epiphysis (SCFE).
  • Neuromuscular Disorders: Cerebral Palsy, Spina Bifida, Muscular Dystrophy.
  • Trauma & Sports Injuries
  • Gait Abnormalities: In-toeing, out-toeing, flat feet, toe-walking.
  • Infections & Inflammatory Conditions: Septic arthritis, osteomyelitis, juvenile idiopathic arthritis.

Conservative, growth-guided care is what our approach is rooted in at NMC. Whenever possible, we advocate for non-surgical interventions as we strongly believe that a child's growing body has a remarkable capacity for remodelling and correction. Physiotherapy, custom orthotics or braces and casting techniques like the Ponseti method for clubfoot are usually our first-line treatments, to reflect our driving philosophy.

When surgery is necessary for conditions like severe scoliosis, hip dysplasia, or complex fractures, our paediatric orthopaedic surgeons employ the most advanced, minimally invasive techniques appropriate for children. For limb correction, this includes guided growth surgery and for joint issues, we use arthroscopic procedures. Every surgical plan is made with the child's future growth in mind and supportive care is offered all throughout. This extends from pre-operative counselling designed to alleviate a family's anxieties to child-focused post-operative rehabilitation. A consistent, compassionate and expert standard of care is offered across all NMC facilities, whether a child needs assessment in paediatric orthopaedics across Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain.

Highly qualified consultant paediatric orthopaedic surgeons sit on our teams at NMC. They have all undergone dedicated fellowship training in this sensitive subspecialty and bring experience from leading international paediatric centres. This is coupled with their deep understanding of the needs of families in the region. Paediatric anaesthetists, specialised physiotherapists, orthotists and nursing staff who are all trained in child-friendly care, are all part of the wider support system.

We recognise that a child's orthopaedic problem can be a source of great worry for parents and can be quite overwhelming for the child themselves. Our consultants possess exceptional communication and bedside manner and are commended in the way they help make this process smoother for parents and child. Their surgical precision is unmatched and they actively involve both parents and child in the decision-making process. Our team provides reassurance, expertise and personalised attention needed to navigate this journey successfully. This can help families searching for a trusted paediatric orthopaedic surgeon across Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain.

FAQs

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Frequently Asked Questions

Absolutely not. Many cases of scoliosis, particularly milder curves can be managed successfully through careful monitoring and bracing. Surgery is only recommended if curves are more severe, progressive or likely to worsen significantly with future growth.
Highly effective, the Ponseti method is a non-surgical treatment for clubfoot. In the first weeks of life, it works to gradually correct the foot’s position through a series of gentle manipulations and plaster cast applications. This is usually followed by a minor outpatient procedure known as a tenotomy and several years of wearing special braces at night to maintain the correction.
Many heal well but require careful attention. Because the growth plate is responsible for future bone lengthening, improper healing can lead to growth arrest or deformity. All suspected growth plate injuries, to best outcomes, should be assessed and managed by a specialist in paediatric orthopaedics.
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