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5 Common Child Orthopedic Conditions

As surgeon, you may receive a lot of parents who love to see their kids running, playing and enjoying life with a healthy body.

Every day, children are born with various orthopedic conditions that can seriously affect their lives if left untreated.

A kid’s needs are unique. Parents will seek care from you, who are dedicated to providing personalized child-friendly treatments and to inform them about the conditions that their kids may have.

1. Flat Feet

Most of children are born with a very little arch in their feet. As they grow and walk the soft tissues along the bottom of the feet, which gradually shapes the arches of the feet. Children with flat feet don’t develop an arch until around 5 years or older and some of them never develop an arch. If this continues into adolescence, a child may experience aching pain on the bottom of the foot.

The treatment for flat feet is controversial but there’s a consensus opinion that this condition reduces with ages and most of the children are asymptomatic.

Surgery is rarely required unless the condition is inflexible. In 2016, researchers at the University of Granada, proved that the barefoot running, decreases the chances of suffering an injury and that supports significant changes in the way the foot is supported when making contact with the ground. The study, examined 39 volunteers who took part in a progressive program of exercises barefoot, on grass.

“The mechanical behavior in the lower extremities, together with an excessive transversal movement of the ankle, appear to be closely linked to the development of chronic injury.” said Professor Víctor Manuel Soto Hermoso from the Department of Physical and Sports Education, which is one of the authors of the study.

2. In & Out Toeing

In and Out toeing are very common in children and it may appear during various times of childhood development. The feet turn inward or outward instead of pointing straight ahead. It is also referred as “pigeon-toed”.

It is often noticed by parents, right from the moment that children starts walking but the truth is that this condition can appear any time for different reasons, such as:

  • Curved foot;
  • Twisted shin (a tibial torsion) ;
  • Twisted thigh bone.

This conditions can occur by their own or in association with other orthopedic problems.

In the past, the treatment for this kind of orthopedic conditions was supposed to go through complex shoes, braces or casts to correct the deformity but nowadays the current research has navigated away from this.

In very rare cases, this situation may lead to surgery that usually entails fracturing a bone at the involvement of the leg, rotating to make the leg straight and finally applying a cast so the bone can heal in the correct position.

3. Bow legs

When a child with bowed legs stand up with their feet together, there is a distinct space between both legs and knees. It is normal to see bowed legs in toddlers and children under 3 years old, however if a child doesn’t grow out of it after that time, treatment should be consider.

Surgery should not be the first option, however most of the times bowed legs surgery can be the only solution. There are many risks posed, such as:

  • Removing, breaking and straightening certain bones;
  • Bone infection;
  • Nerve damage;
  • Metal clamps on legs;
  • Unsightly scarring.

The most common type of surgery for this situations is osteotomy. Osteotomy, literally means cutting off the bone, in an osteotomy either the tibia or femur is cut and then reshaped. This surgical procedure helps correct the bow legs by targeting the point of alignment of limb and paralleling the knee and ankle joint. It takes about 2 months to recover of this surgery.

4. Knock Knees

Knock Knees are angular deformities at the knee, in which the head of the deformity points inward. It is very typical in young children, but if a parent let them reach through teenage years, with this condition, or even adulthood it can become a serious problem. Not only this problem can cause complications in the knee but it also cause them great deal of embarrassment if you don’t take care of it.

A kid with knock knees has a large gap between their feet when they’re standing with their knees together and it can become more obvious at around the age 4.

Knock knees that develop later in childhood or don’t improve with age can sometimes be related with a primary problem:

  • Problems with bone development resulting from a lack of vitamin D and calcium- known as- Rickets;
  • Excessive pressure on the knees;
  • An injury or an infection affecting the knees or leg bones;
  • Genetic conditions.

There isn’t a specific treatment for knock knees. Most of the times it disappears as the child grows. Tell parents that their child doesn’t need to wear any type of braces or do any special exercises. Surgery for knock knees is rarely necessary.

At the age of 3, more than 20 percent of children have at least a 5 centimeter gap between their ankles. By the age of 7, only 1 percent of children have this gap.

5. Toe Walking

Toe walking refers to a walking pattern where a child walks on the balls of their foot and there’s no contact with the heels and the ground.

When children start walking, they try different foot positions. By around 2 years old, they should walk with their feet on the ground and on the most of the times this isn’t something to be concerned about.

On 2012, a study published in Pediatrics showed that most of the children who did toe walking, stopped doing it at the age of 5 and most of toe walkers didn’t have any developmental or neuropsychiatric problems. However, it’s concerning if it keeps on.

Kids who spend their time walking on toe can develop stiffness, tightening and pain in their Achilles tendon which can be treated with physical therapy and stretching exercises. As the previous condition, it’s rare to put a kid into surgery.

Surgeons, every time a parent reach out to you because a preschool teacher said to them “you should take your kid to a doctor and get him checked out” remember that they are only looking for the best to their child. Even if, most of the times, it seems that they shouldn’t be worried. Remember: they’re looking for help. As long as the child is developing properly and without any other conditions, let them perceive that everything will be fine.

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