Patient Information Resources


Long Island Spine Specialists, P.C.
763 Larkfield Road
2nd Floor
Commack, NY 11725
Ph: (631) 462-2225
Fax: (631) 462-2240






Child Orthopedics
General
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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After watching our two-year old waddle around and thinking it was cute, we finally realized at age four that there was something wrong. The pediatric orthopedic calls it an angular deformity of unknown cause. Is this something our son will outgrow?

How cartilage and bones grow and develop is a complex series of steps. There are feedback loops that involve hormones, signalling pathways, and as yet unsolved mysterious mechanisms. So when something goes wrong and a child develops too much inward or outward angling of the bones, it's not always clear what happened or what to do about it. There may be inherited or genetic factors we don't know about that can affect the final outcome. If the problem is mild, the orthopedic surgeon may advise a "watch-and-see" approach. Bone growth, bone alignement, and closing of the growth plates is different from one child to the next. There is some evidence that individual factors such as activity levels may make a difference. For example, weight-bearing through the joint causes load and pressure that stimulates bone growth. But the bone seems to grow the most when the child is non-weight-bearing during rest or sleep. At age four, there is still quite a few years left for the bones to develop and the child to reach full skeletal maturity. But if the problem looks to be getting worse instead of better, intervention is advised. The optimal timing for correction of the problem remains unknown. Common sense tells us earlier is better but there may actually be an optimal time -- and that "optimal" moment may be different from child-to-child. There is also a guided growth system now available to treat this problem. A flexible band placed across the knee joint and held in place with two screws makes it possible to slowly but safely correct the problem as the child grows. This management tool is quickly replacing the old method of surgical osteotomy (removing bone to change the tilt or angle). Your surgeon will guide you through this time of watching, waiting, and intervening as needed. Knowing about the different treatment options will help you ask questions and get the best treatment available for your child. This is especially true if it starts to look like the problem isn't going to self-correct early on.

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