Pediatric Orthopaedic Conditions We Treat
Mount Sinai’s pediatric orthopaedics team is skilled in treating scoliosis as well as the full range of conditions affecting the growing musculoskeletal system, including the following:
- Cerebral palsy: Cerebral palsy (CP) impairs a patient’s ability to control their muscles, causing varying levels of disability. Children with mild CP may be able to walk on their own, while those with severe CP may have to use a wheelchair.
Treatments for CP include medication, physical therapy, and braces, which can help significantly when started early.
- Clubfoot: Occurring in approximately 1 in 1,000 births, clubfoot is a condition in which the foot is turned to the side, with the affected foot, calf, and leg being smaller than normal. Clubfoot is not painful, but, if untreated, the condition could lead to disability as the child grows.
Treatment for clubfoot should be initiated as soon as possible to ensure the best outcomes. Therapies that involve casting and bracing have been increasingly successful in correcting this condition without surgery.
- Developmental dysplasia or dislocation of the hip: In infants and children with developmental dysplasia or dislocation of the hip (DDH), the hip joint has formed improperly so that the ball does not fit the socket, causing symptoms that include legs of differing lengths, decreased mobility, and limping. In mild cases, the ball is loose in the socket; in severe cases, the ball is completely dislocated.
Treatment for DDH ranges from the use of a harness or brace (if the condition is caught in an infant) to surgical procedures (if the condition is not caught until later).
- Fractures/injuries: Fractures could be caused by an injury forceful enough to break a bone. Ten percent of all arm fractures in children occur around the elbow.
Depending on the nature of the injury, treatment could be nonsurgical (such as splinting or casting) or surgical.
- Kyphosis: In kyphosis, the back is abnormally rounded due to a significant spinal curve. Different types of kyphosis cause varying degrees of disability.
Treatments for kyphosis vary, ranging from exercise and anti-inflammatory medication to surgery for cases in which the curve exceeds 75 degrees.
- Osteogenesis imperfecta: In osteogenesis imperfecta (OI), the body is unable to make strong bones, which could cause deformities and lead to frequent breaks and fractures. Caused by a genetic defect, OI can occur in a mild or severe form.
Treatment for OI ranges from nonsurgical therapies (such as medication and exercise) to surgical procedures (such as the insertion of metal rods).
- Osteomyelitis: Osteomyelitis is an infection in the bones that could become chronic without timely medical care.
Treatment for osteomyelitis could involve antibiotics and the removal of infected tissue.
- Overuse injuries: Typically the result of repetitive sports activity without sufficient rest or stretching, overuse injuries can impact growth plates, ligaments, muscles, and tendons. Bone growth occurs before muscle and tendon growth, which puts strain on muscles and tendons. Types of overuse injuries include jumper’s knee, throwing injuries to the elbow, and stress fractures.
Treatment for various overuse injuries includes stretching exercises, non-steroidal anti-inflammatory medication, immobilization, casting, and bracing.
- Rickets and osteomalacia: In rickets and osteomalacia, low levels of vitamin D cause bone weakness, pain, and deformities.
- Scoliosis: Common in many children and adolescents, scoliosis is a sideways curve in the spine that could resemble an “s” or “c” shape.
Treatments for scoliosis depend on the severity of the curvature and the age of the child. In many cases, treatment could involve monitoring with regular x-rays or bracing. For severe cases, surgery is commonly required.
- Spondylolisthesis: Resulting from a congenital defect or stress fracture, spondylolisthesis can cause the bony structures in the lower spine to shift. The condition can be painless or cause low back pain and spasms. Severe slippage of these structures could narrow the spinal canal and compress the nerves.
Treatments for spondylolisthesis may include rest and anti-inflammatory medications. In some cases, physical therapy and a back brace may also be recommended.