Children's Orthopedics

My 10-year-old niece is in the hospital having her knee drained because of an infection in the joint. They said it usually clears up with one session of drainage. She'll be on antibiotics for awhile. What if it doesn't clear up? Then what?

Joint infection called infectious arthritis or septic arthritis can be cause for hospitalization. Early diagnosis and teatment is important for successful results. Antibiotics and surgical drainage are the gold standard for this condition. Without adequate treatment, complications can occur.




Please help us -- our seven-year-old grandson has septic arthritis of the hip. He's been hospitalized for treatment. There's a real concern about the infection going into the bone. What would cause this to happen? Can we do anything? How likely is it? I'm just so worried, I can't think straight.

Most people are familiar with strep throat or a staph infection in children. But these bacteria can enter the bloodstream and travel throughout the body. For some as yet unknown reason, the bacteria take up residence in the joints and cause a septic (infectious) arthritic response.




In our community, there is a special digitized computer that can be used to measure scoliosis. We have some baseline X-rays already taken of our 11 year-old daughter with this problem. The computerized method costs more. Is it more accurate?

There are many advantages of the updated digitized and computerized technology used to measure scoliosis (curvature of the spine) compared with standard X-rays. In both methods, a measurement called the Cobb angle is determined.




Every time we take our daughter in for scoliosis checks, a different person reads the X-rays. Wouldn't it be better if just one person measured and remeasured her? I just don't trust that the changes we are being told are present aren't because of the way the measurements are taken.

You raise a valid concern about intraobserver and interobserver reliability. Intraobserver reliability refers to how well one person can make the same measurement more than once. Interobserver reliability is the accuracy of those measurements when more than one person measures the same thing.




We took our son to a specialty clinic for surgery on his knees because he was extremely bow-legged. There's a special name for this condition (Blount disease). That was last year. Now this year, they have sent him a questionnaire to fill out about his pain, satisfaction level, and function. He's only nine years old! How can he answer questions about his satisfaction with the surgery or his quality of life?

Patient satisfaction surveys are becoming more and more common all the time. Hospital administrators, insurance companies, and even surgeons want some way to measure the results of the procedures performed. Patient satisfaction and quality of life ratings can be ways to measure success.




We are making decisions for our six-year-old daughter that she will have to live with for the rest of her life. She has a condition called Blount disease (bow legs) and may need surgery. Is there any information on how these kids feel about their results years later (like when they are adults)?

Blount disease is a condition of bowlegged knees, also known as tibia vara in medical lingo. Surgical correction aims to create a more normal angle between the lower end of the femur (thigh bone) and the upper portion of the tibia (lower leg bone). Children with Blounts disease often need surgery to restore normal knee alignment and reduce pain. The result is decreased disability and improved function.




My new grandbaby has a dislocated hip. I guess he was born that way. They are not sure if this is a genetic thing or if he got into a bad position inside the womb. In any case, since it's only one side, will it heal up better than if both hips were affected?

Developmental dysplasia of the hip (DDH) is a common disorder affecting infants and young children. In this condition, there is a disruption in the normal relationship between the head of the femur (thigh bone) and the acetabulum (hip socket). DDH can affect one or both hips. It can be mild to severe. In mild cases called unstable hip dysplasia, the hip is in the joint but easily dislocated. More involved cases are partially dislocated or completely dislocated.




Our baby has a hip problem they want us to use an ugly old harness thing to hold his legs apart. Do we really need to do this? Won't he outgrow this problem? It looks like some kind of torture device.

It sounds like you are describing the Pavlik harness, first designed and used by Dr. Arnold Pavlik in the 1940s. It's not exactly new, but it's not from the dark ages, either. In fact, it's been around long enough to show how successful it really is. Success rates range from 61 per cent up to 99 per cent. The harness has become the number one treatment choice for babies birth to three months old.




Patient Satisfaction After Surgery for Blount Disease

Children with Blount disease often need surgery to restore normal knee alignment and reduce pain. The result is decreased disability and improved function. Blount disease is a condition of bowlegged knees, also known as tibia vara in medical lingo. Surgical correction aims to create a more normal angle between the lower end of the femur (thigh bone) and the upper portion of the tibia (lower leg bone).




Hip Dislocation in Children: Predicting Treatment Success

Sixty years ago, Dr. Arnold Pavlik designed a special harness for the treatment of developmental dysplasia of the hip (DDH). It is still in use today as the number one choice for this condition in babies.





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