Surgery may be necessary for contractures or scoliosis. Osgood-Schlatter disease is an overuse injury in the knee area of growing adolescents. There are several treatment options for Osgood-Schlatter disease including rest, ice, pain medication, physical therapy or a knee strap. Osteochondritis dissecans is a condition in which there is a damaged area of cartilage and underlying bone within a joint, most commonly the knee or elbow.
This may be treated with surgery or with bracing and rehab alone, depending on the nature of the lesion. Treatment may include medication, casting or bracing.
In the rehabilitation of paraplegics reconstructive and corrective operations play a not unimportant part. Their chief value lies in assisting conservative measures. Orthopaedic Surgery of the Limbs in donextturnewsra.tk L. S. Michaelis. 10 × 6¼in. (In English.) Pp. 62, with 30 illustrations. Berlin: Springer‐Verlag. Stiff paper.
Surgery may be necessary for fractures that do not heal, recurrent fractures of the same bone or for scoliosis. Osteomyelitis is a bone infection. This condition requires immediate treatment. Typically, the infected bone is removed and intravenous antibiotics are administered for a prolonged time. Once the infection is gone, the bony deficit requires reconstruction. Small deficits may heal or require bone grafting.
Large deficits require more extensive surgery to bridge the defect. Out-toeing — Some children may turn their feet out at rest or when they walk. There are many potential causes for this, which will be evaluated. In many cases, no treatment is needed; however, depending on the underlying cause, treatment with surgery or physical therapy may be required. Patellar instability is a condition in which the patella or kneecap does not track smoothly in its joint. This may be treated with focused physical therapy and bracing or surgery in some cases. This deformity occurs during pregnancy.
Polydactyly is treated with surgery to remove the extra digits. Radial deficiency is a condition where the radial radius bone side of the forearm fails to develop normally during pregnancy. The extent of involvement is variable. Mild cases have mild shortening of the radius and a normal hand.
Severe cases have complete absence of the radius and a missing thumb. Treatment may require centralizing the wrist on the end of the remaining ulna forearm bone to make the forearm straight.
Additional thumb reconstruction via pollicization surgery that makes the index finger into a thumb is often necessary. Rickets is a metabolic bone disease that causes weak bones, bowed legs and other bone deformities.
Treatment for rickets may include vitamin D and calcium supplements or bracing. Surgery may be required for severe cases only. Scleroderma is a condition that includes chronic hardening and tightening of the skin and connective tissue.
Neurosurg Focus ;E6. An ambulatory child is able to walk around independently, whereas a non-ambulatory child requires mobility aids , such as crutches, walkers or wheelchairs, in order to move about. Concussion The term mild traumatic brain injury TBI is used interchangeably with the term concussion. Eventually blood flow is restored, dissolving the flattened part of the bone and replacing it with new bone. Effects of combined open kinetic chain and closed kinetic chain training using pulley exercise machines on muscle strength and angiogenesis factors. Insufficient recovery requires secondary surgery that may include joint release, tendon transfer or osteotomy. The injury can be a complete blockade or incomplete barrier that allows some signals to traverse the injured segment.
Treatment may include medication and physical or occupational therapy. Surgery may be necessary for complications caused by scleroderma. Scoliosis is a progressive condition causing the spine to curve. Treatment may include bracing with custom orthoses made in-house. See Scoliosis and spine care page. Leaders in scoliosis evaluation and innovative treatment We provide worldwide expertise in the evaluation and treatment of children with scoliosis. Non-operative treatment utilizing physical therapy and bracing is helpful in most children.
Progressive deformity requires surgery to prevent severe spine curvature.
Slipped capital femoral epiphysis is a condition when the upper end of the femur slips backwards in the hip socket, causing hip pain. Surgery is necessary to prevent further slipping. Solitary and multiple hereditary exostoses are tumors that sprout from the bone; usually bone covered by cartilage. Multiple hereditary exostosis requires a team of experts and the bone tumors can grow anyway in the upper extremity, lower extremity and even the spine.
Exostoses are removed if they are causing pain, deformity or neurologic problems. Surveillance is necessary into adulthood and there is a small chance that benign exostosis can degenerate into a cancerous lesion chondrosarcoma that requires removal. Spina bifida myelodysplasia is a congenital defect of the spine where the spinal cord and its coverings meninges are exposed through a gap in the backbone.
The initial care to address the exposed spinal cord and hydrocephalus is provided by a neurosurgeon. Orthopaedic evaluation and treatment for children with spina bifida begins after the neurosurgical intervention. Some children with spina bifida benefit from a custom wheelchair and seating assessment to improve mobility and prevent pressure areas. At Shriners Hospitals for Children — Philadelphia, we practice a multidisciplinary team approach including rehabilitation care, assistive technology, wheelchair and seating clinic, motion analysis center, neurology, neurosurgery, orthopaedics, orthotics bracing , urology and nutrition services.
Spinal cord injury is damage to the spinal cord usually related to trauma, such as motor vehicle accident, sporting injuries or violence. The injury can occur at the cervical neck level, the thoracic chest level or the lumbar lower back level. The injury disrupts the signals that travel from the brain to the spinal cord and prevents them from reaching their downstream targets. The injury can be a complete blockade or incomplete barrier that allows some signals to traverse the injured segment. Cervical spinal cord injury affects the arms and legs tetraplegia.
Thoracic and lumbar spinal cord injury spares the arms and affects the legs paraplegia. The initial injury requires immediate management to prevent any additional injury to the spinal cord. Many medical issues also require management, as the injury to the spinal cord affects many other homeostatic systems such as blood pressure. We provide worldwide expertise in the evaluation and treatment of children with spinal cord injury.
Once the spine is stabilized, extensive rehabilitation is necessary that requires a multidisciplinary team, including rehabilitation specialists, spine surgeons, therapists, urologists, phycologists, nurses and social work. Although not required, we also perform ongoing clinical research to carefully assess our outcomes following treatment.
We also are devoted to basic science research in the effort to find the cure for spinal cord injury. We offer non-operative and operative management.
Therefore, children with spinal cord injury are best cared for at an institution that specializes in the care and treatment of spinal cord injury. Too much abnormal motion of one vertebra on another can cause pressure on the spinal cord and nerves. Treatment for this disorder requires regular clinical exams, X-rays and possible bracing. Spinal muscular atrophy is a group of disorders of the motor cells in the spinal cord and lower brainstem, which leads to muscle weakness and atrophy.
This condition is typically inherited.
Treatment for spinal muscular atrophy may include physical therapy, respiratory care, splints, spinal orthoses or surgery. Spondylolisthesis is the slipping forward of a vertebra over a lower segment, which causes back pain. Treatment for spondylolisthesis may include medication, steroid injections, physical therapy or bracing. Surgery may be necessary to prevent further slipping. Spondylosis is a defect or crack in the back part of the vertebra, which causes back pain. Spondylosis can occur in the cervical neck or lumbar low back spine areas.
Treatment for spondylosis may include medication, steroid injections, physical therapy or bracing. Sports injuries include strains, sprains or overuse injuries to the bones or ligaments, tendons or muscles from athletic activity. Recommended treatment for sports injuries includes RICE: rest, ice, compression, elevation; medication; bracing, casts or splinting; and physical or occupational therapy.
Some forms of syndactyly are inherited while some forms occur sporadically. Treatment of syndactyly varies by child; therefore each child will be evaluated by a team of hand and foot specialists to decide a treatment plan. Sometimes the hand functions well without surgery and sometimes surgery is required to separate the fingers and deepen the space between the fingers. Synostosis is a condition whereby the joint between two bones fails to form normally during pregnancy and the bones are fused together.
Any joint in the body can be affected, including the spine, arms or legs. The child is born with a stiff joint and absence of skin creases across the affected joint.
Synostosis can involve one or more joints in the body. Surgical treatment is difficult and efforts to make a joint have been disappointing. Physical and occupational therapy is helpful in facilitating walking and activities of daily living. Tarsal coalition is an abnormal connection of the two bones at the back of the foot, causing foot pain. Surgery may be necessary to improve function and reduce pain.
Tethered spinal cord is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord in the spinal column.