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Children's Orthopedics

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We provide professional support in Children’s Orthopedics.

Description

Children’s Orthopedics

It deals with gait disorders, deformities, limb length differences and fractures,
especially in children aged 16 and under. The general approach is to
evaluate children as individuals with a unique anatomy and physiology, unique
diseases and a specific treatment for each disease rather than being small
people. 

Clubfoot (Clubfoot- Pes Equınovarus)

This condition can be detected as soon as the child is born. Deformity has 3
main elements: The shape of the toe pointing downwards, the folding of the foot
and the inward facing of the heels. When these three are combined, the
deformity that we call crooked foot and the foot in which the foot is hunched
inward appears.

It is necessary to start treatment as soon as possible. Because the delays
experienced cause the deformity to become more resistant to treatment. The
aim is to provide a painless foot that will not cause trouble for our baby to
walk on as soon as possible. It is important to complete the treatment at
the latest before the child starts to walk.

The chance of getting a response to the treatment is very high with serial casts
applied weekly with the Ponseti method. It is a treatment process that
takes between 6 and 12 weeks. After the treatment process, it is evaluated
whether the heel is recovered sufficiently and if necessary, a small correction
operation may be required for the Achilles tendon. After the treatment,
the treatment is ended by using special shoes for 2 months. In some
resistant patients, it may be necessary to apply relaxation and lengthening
procedures to the ligaments, tendons and joint capsules in the foot.

Developmental Hip Dysplasia (Congenital Hip Dislocation)

Generally, it is the condition where the hip is not in place. This is either a fully
dislocated hip where the femur is completely disconnected from the hip bone
(femur) and the acetabulum in the hip, or a semi-dislocated hip in which
harmony is broken but part of the thigh bone is outside or displaced upwards,
or the ligament of the joint is more than normal. It describes the hip that it
can climb with special maneuvers (Barlow maneuver) due to its looseness. 

Congenital hip dislocation occurs in the early stages of pregnancy due to genetic and
hormonal reasons, while it is due to the baby’s inability to complete its
return in the mother’s womb or pressure on the hips in the late stages of
pregnancy. The use of swaddling after birth causes hip dislocation.

When making a diagnosis, the first thing to do will be a detailed physical
examination. Early hip ultrasound for screening is important. From
the 4th month, hip x-ray is important.

When planning the treatment, it is done depending on the cause and the time when the
disease is detected. In its form due to genetic diseases, surgery may
generally be required in the early period. However, if it is diagnosed
early in its form due to mechanical reasons, it can be treated with special
bandages. In case of late diagnosis, it is treated with plastering
treatment from the 6th month and by surgery after the age of 1.

Things to Consider with Hip Dysplasia

If you have trouble opening the hip or feel restless while changing the diaper of
your baby,

If the folds in your baby’s legs are not symmetrical,

If it is delayed in walking,

Has a limp when walking,

If you notice a difference in length between their legs,

Always talk to your doctor.

Flat Insoles

All children are born with flat feet. With time, the arch of your feet begins
to form. In other words, flat feet we see in children is a physiological
process. It does not require any special treatment until the age of 6.

It will be sufficient to pay attention only to the choice of shoes.

Flat feet can be seen in 2 subgroups. Loose flat feet and rigid flat
feet. In loose flatfoot, the arch of the foot is lost only when
stepping. In solid flat feet, the foot arch does not form in any
way. There may be an underlying problem in patients with rigid flat feet.

The diagnosis of flatfoot is made only by examination. But if there is a hard
flatfoot, it may be necessary to make a diagnosis by performing
examinations. If there is a situation that needs to be intervened by X-ray
and tomography, if necessary, it should be detected.

Things to Consider Regarding Flat Insoles

If your child has flat feet, it is probably a physiological process. You
don’t need to be afraid.

If he continues at the age of 3, his control will be appropriate. If there is
a hard flat foot, that is, if the arch of the foot is not formed in any way,
early control will be appropriate.

Push In

Normally, adults walk with their feet straight or slightly outward while
walking. But introversion is very common in children. In general,
intrusion occurs due to deformities in the hip and knee. However, in
general, most of these disorders are generally tolerated by the
body. Walking returns to normal over time. In some cases, in cases
where the disorder is really advanced, surgery may be required very rarely.

Congenital Knee Dislocation (Congenital Knee Dislocation)

In fact, although it is a very rare disease, we felt the need to provide
information because we encountered it more often than usual in our
clinic. It is a dislocation of the knee ligaments due to hormonal or
genetic diseases. The diagnosis can only be made by image and
examination. It is necessary to start treatment immediately. The knee
is brought to its normal position with serial casts. Plasters are made 1
in 10 days on average. It is treated with a special device after
plastering. If the knee still does not return to its normal position after
3 months, it is performed with surgery and a plaster cast is required for a
while after the operation. Patients are likely to have hip dislocations
and should be careful.

Perthes Disease

Although it is a rare condition, it is necessary to be careful because it is difficult
to diagnose and treat. Although it appears with hip pain in childhood, it
can sometimes appear as frequent knee pain. It is caused by impaired blood
circulation of the hip bone with an unknown cause.

The disease manifests itself as recurrent hip and knee pain in
particular. Pain increases especially with sports activities. It
passes with rest. During the disease, there may be a loss of the normal
roundness of the thighbone (femur) head with the deterioration of the bone
nutrition in general and it tends to come out of the femoral socket with
deformity. In the treatment, strict follow-up and, if necessary (rarely
necessary), surgeries that help keep the hip in the socket are performed.

The course of the disease is very variable. Results are better in patients who
start at an early age. Sometimes, despite the surgeries, satisfactory
results may not be obtained. But the main thing in treatment is to follow
the patient in appropriate periods and to make appropriate interventions on
time.

Osgood-Schlatter and Saver’s Disease

They are common diseases in children who play sports. Osgood-schlatter
manifests itself as swelling and pain in the lower part of the knee. Sever’s
disease manifests itself as pain in the heel.

Osgood-Schlatter is caused by forcing the anterior part of
the knee growth plate, and sever’s disease is due to the forcing of the heel
bone (calcaneus) growth plate.

Similarly, in these two diseases, there is pain that
increases with activity and decreases with rest. Although recurrent pain
frightens families, they are common illnesses. In fact, even the word
illness is exaggerated. Although rest restriction is generally required in
treatment, it may be necessary to use some special knee pads and insoles
rarely. But what is important in treatment is personal planning.

Slippage of the Femoral Head Pineal

Thigh bone (femur) is the discomfort caused by the erosion of the growth plate close
to the hip joint. It is especially seen in slightly robust boys. It
generally manifests itself as severe pain after activity. It is very
important to diagnose it in time. It needs to be diagnosed in the early
period and operated. The femoral head begins to shift at the level of the
epiphyseal plate in untreated cases. Before the treatment starts to slip,
it is fixed with pins or special screws.

Childhood Fractures

Childhood is important for fractures. The beautiful part is that children can
tolerate skew joints in the bones up to a certain extent because of the
reconstruction process called remodeling in the bones in children, and almost
the bone fracture can be completely corrected despite the initial
curvature. However, this process requires some time. Of course, this
situation is excluded in some special fractures.

Elbow Fractures

The elbow area is the area where the humorous and forearm bones join. It is an
important area. It is also important because the veins and nerves leading
to the arm pass through this area. It is necessary to be very careful in
both the treatment phase and the follow-up phase in fractures in this
area. Skipping circulatory disorders and late intervention causes
permanent problems. Early intervention of the fracture is very important,
especially in fractures in the region of the humorous close to the
joint. While some of the fractures in this area require immediate surgical
intervention, some may require surgery because the proper position cannot be
provided, and some may require surgery due to loss of position in the
follow-up.

Elbow joint is an area where the remodeling process is weak. Therefore, it is
important to ensure complete and correct boiling. Otherwise, it should be
kept in mind that there may be deformities that will affect the whole life.

Below Elbow Arm Fractures

The area called the forearm is the area between the elbow and wrist and consists of
two bones. It is the radius bone on the thumb side of the wrist and the
ulna bone on the side of the little finger. Fractures in this area may
require surgery depending on the location and age of the patient.

While excellent results can be obtained without surgery in early childhood, surgery
may be required in advanced childhood. Fractures in this area also require
full anatomical treatment in order for the hand to fully show its functions.

Contrary to adults, this area is the most comfortable area close to the wrist. In
fractures in this area, it is easier to maintain the anatomical position of the
bone without surgery compared to other parts. However, it should be kept
in mind that in fractures in this region, anatomy cannot be achieved almost
completely or surgery may be required in some special fractures and fractured
dislocations.

Leg Fractures

While the part above the knee, that is, the thigh region, consists of a bone called
the femur, the part below the knee contains the tibia and fibula bones known as
the tibia. Treatment in this region also varies according to the age of
the patient. While treatment with plaster and splints is possible in the
early stages, surgery may be required in the future.

Since it is a weight-bearing area, it is important to provide full anatomical bone
integrity in the treatment. In this region, limping, shortness,
deformities and outward pressing of the foot can be observed after
inappropriate treatments.

Things to pay attention

If we think of a fracture, the first thing we will do is to fix it in a way that
restricts the movement of the broken area and does not disturb the circulation.

If possible, ice should be applied immediately.

It is necessary to consult a doctor immediately.

Surgery always sounds unpleasant to hear, but your doctor will never operate on your
most precious treasure in vain, the important thing in fracture treatment is to
recover without any loss of function.

Additional information

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