As parents, both surgeons at the Cape Joint Surgery understand how distressing orthopaedic problems in children can be for the parents as well as kids. Children are not young adults and they should never be treated as such. Therefore the joint care for children is different to that of adults. Conditions which would be commonplace in a middle-aged patient, such as joint pain or a limp may be the only evidence of a serious and potentially irreversible problem in a child. There is no doubt that one can never be too careful where children are concerned.
Children may insidiously developed a condition known as septic arthritis or osteitis, which may affect any of the major joints or the bones close to them. This is a potentially life-threatening problem if the diagnosis is not made early and appropriate treatment is not instituted. Symptoms are often mild at first and may frequently be put down to bruising after a minor traumatic injury.
Children’s bones break differently to adult bones and the treatment is always different. Surgery is far less often required. This is due to the fact that children’s bones can grow straight over a period of time, provided they have enough growth potential remaining. Fractures into the growth plates, which are areas of active bone growth require specialist assessment in order to prevent delayed growth disturbance, which is difficult to manage and may often result in shortened limbs. Generally speaking, children’s fractures heal roughly twice as fast as a similar fracture in an adult.
Some childhood conditions are are due to congenital abnormalities and some may be due to “packaging problems” in a tight womb. While many of these conditions are obvious at birth due to visible deformities, for example club feet, others may be missed unless specifically looked for and examinations for some of these problems are amongst the most difficult in orthopaedics. Based on the fact that growth potential decreases exponentially as the child ages, early diagnosis of problems such as hip dysplasia may avoid the necessity for later surgery.
We feel that the most important thing in managing children’s orthopaedic problems is that the child at all times feels comfortable and is never afraid or in pain. At the same time, in a situation where parents may feel utterly out of control, they must be assured that any decisions regarding the management of their child will ultimately be taken by themselves with the orthopaedic surgeon acting in an advisory, rather than a didactic capacity.