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Pediatric Orthopedics and Traumatology

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The first steps of a baby make us not only happy for the little one perceiving the world, but also worried about the risk of various injuries. All the parents are aware of the importance of pediatric orthopedics, while the area of the work of a pediatric orthopedic traumatologist is a mystery for many parents.

An orthopedic traumatologist is the doctor who works in the area of prevention, diagnostics and treatment of locomotor apparatus of children, congenital pathologies and acquired injuries. The specialty is the part of the surgical direction, as most pathologies and injuries need surgical treatment.

Pediatric orthopedic traumatologists with considerable practical experience and knowledge based on the evidence-based medicine and corresponding to the international protocols work with patients at Dobrobut clinic chain.

Which problems can be resolved by an orthopedic traumatologist

Human skeleton is developed from the birth of a baby until the age of 22. Disorders can emerge at every stage that is why a consultation by an orthopedic traumatologist can be needed during any period of growth and development of a child.

A baby has the first check-up by an orthopedic traumatologist already in a maternity clinic just after birth, as abnormal formation of musculoskeletal system can be the result of injuries. However, not every maternity clinic has a pediatric orthopedist, in most cases a newborn baby is examined by a neonatologist that might not notice some orthopedic pathologies. That is why a consultation by an orthopedic traumatologist is needed 10–14 days after birth to receive timely treatment of congenital orthopedic diseases of children such as clubfoot, myogenic torticollis, hip dysplasia, etc.

Even an absolutely healthy baby is not safe from the development of orthopedic diseases because of the anatomic and physiologic characteristics. For example, the skeleton of preschool children is more amenable to various external influences than the skeleton of senior children. Forced loads of the child’s musculo-skeletal system during long periods of standing or sitting in an uncomfortable position, lifting and carrying of heavy objects by a child can cause deformities of feet and vertebral column.

Uneven development of the core, when a child sits improperly and has a slouch can cause pathologies. Such disorders are often characteristic for younger schoolchildren, as deep back muscles responsible for support of the vertebral column are not strong enough when a child is 6 or 7 years old.

The load on the musculoskeletal system of adolescents rises sharply, as endocrine changes affect the skeletal growth. As a result, bones of adolescents expand rapidly, and building-up of the muscle mass needs more time that provokes postural disorders, scoliosis and other more serious pathologies.

Planned orthopedic consultations take place within the first year of the baby’s life at the age of 1 month, 3 months, 6 months, 9 months, and 1 year. Planned preventive examinations should be performed before the enrollment to a kindergarten or a school, and also during puberty (sexual maturation of an adolescent).

Dobrobut clinic chain specialists not only help to timely diagnose the disease and prescribe a corrective treatment but also find an approach to every child taking into account his or her character and particularities. They also teach parents on the measures of locomotor apparatus disease prevention that will help a child to grow healthy, active and vivacious.

Modern pediatric orthopedics and traumatology have made it possible to treat many pathologies and states that affect the development of your child and can impair his or her quality of life in future. Dobrobut offers treatment of the whole host of diseases provoked by locomotor apparatus disorders.

When you should see an orthopedic traumatologist

Besides preventive orthopedic examinations or the cases of the referral from a pediatric physician, some visual factors and collateral situations have to become “red flags” for parents. Some of them are more obvious: for example, if a child was injured, and other less noticeable cases that require timely diagnostics and treatment.

For the parents of babies less than one year of age

Torticollis, hip dysplasia and clubfoot (eversion or inversion of the foot) are among the most common congenital pathologies of children less than one year of age.

Myogenic torticollis (congenital) and positional torticollis (acquired) can be suspected if some signs are present that take some time to manifest (while a baby and a mom are in a maternity clinic), but within a few weeks after the birth of a child.

The following symptoms manifesting within the first weeks of baby’s life can indicate the presence of the muscular infant torticollis, when the baby’s head holds a forced curved position:


    • onset of tumidity 1.5–2 cm in size in the neck area (along the sternocleidomastoid muscle); the tumidity often emerges from 3rd to 6th week of baby’s life;
    • complete impossibility to turn the baby’s head in any direction that has manifested at the same time as the tumidity.

Hip dysplasia of a child can emerge influenced by a number of factors:


    • breech presentation;
    • baby’s weight exceeding 4 kg;
    • traumatizing labor.

The sooner the pathology is revealed and the relevant corrective measures are taken, the more effective they are. Hip dysplasia of children older than 1 year progresses rarely, but advanced dysplasia can affect the development of the whole locomotor apparatus of the child and impact the quality of life in future.

Only an experienced pediatric orthopedist can determine the accurate diagnosis, however, there are signs that will help a mom to suspect the development of the pathology:


    • the hip joint is obstructed when turned,
    • asymmetrical folds on posterior surface of the femur,
    • apparent difference in the length of child’s legs.

You can suspect the clubfoot of a child less than one year of age if:


    • a child has a С-shape foot;
    • attempts to gently extend the child’s foot and correct its shape have no result;
    • feet are distorted.

Pathologies of preschool and younger schoolchildren

Any visual curvature of leg joints can be the reason to consult a pediatric orthopedist: X bain or bowleg.

A consultation is also needed if:


    • deformity is visible only on one leg;
    • deformity has not lessened after the age of 5 or 6 years;
    • deformity aggravates with age.

Walking on tiptoes is also a red flag and a reason to see an orthopedist if:


    • a child walks constantly on tiptoes;
    • a child over 2 years of age walks on tiptoes periodically.

Suspected flat foot

Flat foot of children can be not only acquired but also congenital. It is difficult for parents to determine if their child under 3 years of age has this problem, that is why a consultation of an orthopedic traumatologist is required to exclude the pathology or to provide a corrective treatment.

The following symptoms can be the reason to visit a doctor:


    • the child complains of pains in feet;
    • flat foot of the children under 5 years of age is rigid (fixed): the shape of a foot does not change and the arch does not extend even if the child is seated or laid;
    • flat foot is mobile, which means that the height reduction of the arch of the foot increases if the child is not standing, but sitting or lying, and also standing on tiptoes. Only a specialist can determine if the condition requires further correction and the type of correction;
    • a 5-year-old child has a pronounced flat foot.

Specialists of Dobrobut clinic chain will provide the corrective treatment of children’s flat foot and give their recommendations on preventive measures.

An orthopedic traumatologist will help in diagnosing and choosing the correct treatment in case of the following diseases and conditions:


    • Systemic skeletal diseases;
    • Localized diseases such as congenital diseases of upper and lower extremities, diseases of vertebral column, scoliosis included;
    • Poliomyelitis and its consequences;
    • Infantile cerebral paralysis (Little’s disease);
    • Bone and joint diseases such as rheumatoid arthritis, arthrosis, osteoarticular tuberculosis, osteochondropathy, osteochondrosis;
    • Benign tumors (lipoma, fibroma, osteoma, etc.);
    • Consequences of injuries.

A visit to a pediatric traumatologist is urgent in case of child injuries that unfortunately happen rather often. It is strictly forbidden to postpone a visit to a doctor, as this can result in improper regenerative process, and the treatment will take much more time.

You should urgently consult an orthopedic traumatologist in the following cases:


    • a little child has fallen, and there is a tumidity, a hematoma (a bruise) on the body;
    • a child cannot step on his or her foot;
    • a child cannot take an object in his or her hand;
    • it has been longer than 24 hours after the fall on the arm, and the symptoms persist;
    • the tumidity remains even without painfullness and when the child is in the state of rest;
    • the child complains of pain in the joint(s) when moving;
    • the pain emerges during an attempt to lift something heavy, and also when the child is leaning on a foot or a hand;
    • acute and sudden pain in the neck;
    • the neck “is locked up”;
    • pain in knee and hip joints;
    • the child has not had any injuries, but cannot stand on the foot.

Orthopedic traumatologists of Dobrobut clinic chain successfully treat the following diseases and conditions resulting from injuries:


    • Soft tissue injuries (impact injuries, strains, tendon ruptures, etc.);
    • Dislocations, incomplete dislocations of upper and lower extremities, ribs, chest;
    • Fractures of upper and lower extremities, ribs, chest, etc.;
    • Spinal and pelvic injuries.

Diagnostics

Various instrumental diagnostic techniques are applied to diagnose orthopedic problems of a child. Dobrobut clinical chain has all conditions to provide young patients with the possibility to undergo an examination as fast and comfortable as possible.

After a consultation, a specialist will determine the most informative diagnostic technique for your child. Modern medical equipment of the clinic chain guarantees the accuracy of the diagnosis.

Computer-assisted and ultrasound diagnostics


    • Plantoscopy: a fast, precise and informative computer-assisted examination of the foot shape, determining of problem areas, assessment of important characteristics, etc. The examination takes 3–5 minutes, and the reading of the results requires from 10 to 20 minutes
    • Ultrasound: ultrasound diagnostics is a fast, informative and safe diagnostic technique applied in pediatric orthopedics. Using ultrasound waves, a specialist visualizes all the parts of joints and tissues, can assess their functionality, stability, etc. Ultrasound of hip joints is considered the gold standard of fast diagnostics of locomotor diseases, especially dysplasia in babies, not without reason.

Modern X-ray diagnostics and tomography

Modern techniques and usage of the most advanced equipment allow to perform X-ray diagnostics without damage to babies’ health. Only the latest digital devices are used at Dobrobut clinic chain, so a child receives minuscule doses of exposure to the radiation.

The following X-ray diagnostic techniques are available at Dobrobut:


    • Radiography: a simple and fast technique based on the examination of internal organs with electromagnetic radiation. X-ray for children is prescribed in cases when other diagnostic techniques have appeared to be less informative, especially in cases of injuries of a child.
    • Computerized tomography (CT) is one of the most informative X-ray diagnostic techniques in orthopedics. CT allows to obtain the series of images and study not only shape and structure of bones and joints, but also the condition of adjacent soft tissues. The images obtained at different angles are then being processed on the computer, modeled, and a 3D reconstruction of organ, joint, etc. is created.
    • Magnetic resonance imaging (MRI): the technique is identical to the computerized tomography, and the images obtained have no visual differences. However, MRI technique is based not on the use of X-rays, but on the magnetic field, and the radiation is not applied. This diagnostic technique, in contrast to others, is convenient because it is very informative and can be safely performed as many times as needed for a specific clinical situation. MRI allows to obtain a highly precise 3D image of organs, bone and soft tissues in any plane. MRI does not replace CT, and only the specialist has to decide which technique is relevant depending on the situation.

Arthroscopic diagnostics

Arthroscopic equipment allows not only to reveal but also to treat intraarticular traumas and diseases using small punctures. The equipment allows to perform the procedure applying minimally invasive technique that expedites recovery and does not leave cosmetic defects on the body (scars, adhesions).

C-arm electrooptical image intensifier

C-arm operating rack allows to determine the precise localization of the fracture and to perform the accurate bone assembly without incisions, and also allows to determine the precise location of foreign bodies and remove them using a minimally invasive procedure.

Treatment

Specialists of Dobrobut clinic chain use modern effective techniques supported by the evidence-based medicine and corresponding to the international protocols for treatment of children’s orthopedic diseases.

We use the following treatment methods, among others:


    • bone-holding technologies;
    • extension methods;
    • rehabilitation procedures;
    • exercise therapy.

Multidimensional approach to diagnostics and treatment of the diseases and strong partnership with the doctors of other medical areas are important to resolve various orthopedic problems. Experienced orthopedic traumatologists will select an individual treatment based on the character of the disease and individual characteristics of child’s development.

Bone-holding technologies


    • Immobilization with plaster dressings. Immobilization is performed in order to hold a body part in the required position and to create an opportunity for fast recovery. It is one of the main therapeutic techniques in traumatology and orthopedics. Plaster dressings are widely used as a separate treatment of fractures and other injuries, for additional immobilization after elongation dismounting, etc. Application of a plaster dressing is the simplest and the most available type of immobilization.
    • Immobilization with polymeric dressings (Scotchcast, Softcast) is the most modern therapeutic fixation technique. Polymeric dressings are lighter than plaster ones, so they are more comfortable and acceptable for children. Such dressings are waterproof, so you do not have to worry that a child will wet and damage the fixation;
    • Individual polymeric orthoses can be manufactured;
    • The treatment of deformities and such diseases as congenital clubfoot, intoeing, congenital myogenic torticollis, hip dysplasia with removable orthoses of the leading global manufacturers Otto Bock, UNFO, Mitchel, Bebax, etc. However, in some cases the application of a plaster dressing is more preferable type of treatment despite the fact that polymer materials are more convenient. Your consulting physician will explain you the reasons for such a decision.

Rehabilitation therapy

After an injury or a treatment of an orthopedic disease of a child, the rehabilitation period is the most complicated time for the child and the parents. It is required to regain the lost functions or bring them as close to normal as possible. The rehabilitation process is long and complicated, its success totally depends on your and your child’s perseverance and diligence in adhering the doctors recommendations.

Competent rehabilitation therapists of Dobrobut clinic chain will choose an individual complex of recreational procedures that will help in returning to favorite activities. It is very important to support and to motivate a child, especially a little one, that does not understand the importance of rehabilitation, in order to get back to normal life for the whole family sooner.

Exercise therapy

Exercise therapy is effectively used for treatment and prevention of various congenital and acquired diseases of children’s locomotor apparatus. It is difficult to practice physical exercises with a child, but it is very important, as the technique is used not only for treatment, correction and prevention of musculoskeletal diseases, but also inculcates a child into the habits of healthy lifestyle.

Exercise therapy allows to prevent the development of orthopedic disorders, to uniformly strengthen various sets of child’s muscles, to increase the generation of synovial fluid necessary for joint mobility, to improve coordination of movements, etc. It is important to do remedial exercises regularly and correctly, and an experienced physical therapist will choose them and teach you and your child.

Treatment of clubfoot with modern methods

Ponseti method of treatment of congenital clubfoot is used at Dobrobut clinic chain. The advantage of the technique is as follows: a distorted child’s foot undergoes nonsurgical correction. That means that Ponseti method is an alternative to traumatizing surgical interventions applied earlier, today the former method is recognized the gold standard of the global orthopedics in clubfoot treatment.

The method is based upon plastering of a foot; tenotomy (incision of the Achilles tendon) can be applied to improve the correction. The procedure is not complicated and is performed on a child under local anesthesia, and a tendon is completely recovered but with the properly formed foot position. The difference of the method is that the correction is very fast. Modern procedure technique allows to completely correct a baby’s foot deformity in 1.5–2 months.

In some cases a surgical intervention (the link for the landing on orthopedics and surgery) is required to treat congenital pathologies of locomotor apparatus and injuries.

Team

Timely detection of a child’s disease and further applying of correct measures depends not only on parents and their timely visit to an experienced specialist. Complex approach to diagnostics and treatment guarantees fast and positive results. That is why communications between high-class specialists of connected specialties at Dobrobut clinic chain is established on the highest level.

Often a lot of medical specialist, sometimes subject matter experts, are needed to resolve the problem’s with child’s health. Dobrobut clinic chain has the team of specialists that will come to help you and your child; the team includes not only the specialists in orthopedics and traumatology, but also the doctors of other specialties:


    • pediatric physicians;
    • cardiorheumatologists;
    • neurologists;
    • pediatric surgeons and neurosurgeons;
    • diagnosticians (roentgenologists, ultrasound specialists, radiologists, etc.);
    • rehabilitation therapists, physical therapists, massage therapists.

Specialists of Dobrobut clinic chain are qualified doctors who understand the importance of complex approach of care for children’s health, both physical and psychological. All the specialists have considerable practical experience of treatment of children with locomotor impairments based on the evidence-based medicine.

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Our doctors
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Luzan Tatyana Aleksandrovna
Pediatrician

Luzan Tatyana Aleksandrovna

Pediatric surgeon, pediatric orthopedist, pediatric oncologist

17 years of practice

Pediatrician

24 years of practice

Наши сертификаты

Сертифікат № QIZ 804 468 C1
Сертифікат № QIZ 804 469 C1
Сертифікат № QIZ 804 470 C1
Сертифікат № QIZ 804 471 C1

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