Pediatric Orthopedics

Pediatric Orthopedics

Children with orthopedic conditions require special care that takes into consideration their bones, joints and muscles for effective treatment that does not affect the growth and development process. Our doctors are specially trained in the diagnosis, treatment and prevention of pediatric orthopedic conditions, and work together with parents and children to ensure a happy and healthy development for all patients.

There are a variety of orthopedic conditions that specifically impact children and teens, including congenital abnormalities, childhood disease, broken bones, playground accidents, sports injuries and aches and pains associated with the growth spurts of puberty.

Depending on the type of injury or disease, children with these conditions may experience abnormal muscle tone, impaired balance, weakness, poor coordination and a decrease in functional movement, in addition to pain, swelling and bruising.

Highlighted Conditions

Congenital Deformities

While children are at risk for many of the same injuries and conditions as adults, they are also susceptible to certain congenital conditions that may affect their ability to walk or perform other everyday tasks by themselves. While many children grow out of these conditions naturally over a certain amount of time, some may require ongoing treatment to maintain or restore function in the affected area.

Some of the most common childhood conditions include:

• In-toeing (pigeon toes)
• Bowlegs
• Club foot
• Flat foot

Our doctors will provide specialized care to correct these deformities and allow your child to experience a happy and healthy life.

Injuries

Because of the fragile nature of growing bones and joints, children are often at an increased risk of experiencing injuries such as a fracture, sprain or dislocation. Children are also usually more active than adults and likely to experience injuries or accidents during physical activity.

Fortunately, many of these injuries tend to heal easier in children because their bones are strong and flexible, allowing your child to quickly return to normal growth and activity with little to no long-term damage. Conservative treatment such as casting, rest and immobilization are often effective in treating these injuries.

Neurological Conditions

Children with certain neurological conditions often experience muscle deformities or imbalances that require long-term care so that patients can experience a certain quality of life and degree of independence regardless of their condition. We provide treatment programs for cerebral palsy, spina bifida and muscular dystrophy, among others, to help patients gain function in affected areas.

Treatment for some of these conditions may require surgery to correct structural abnormalities, as well as ongoing physical therapy programs customized for each individual patient.

Foot & Ankle Replacement Surgery

Foot & Ankle

We specialize in the medical and surgical treatment of pathologies of the foot and ankle. This includes injuries, malformations, conditions and diseases in adults, children and seniors, as well as rehabilitation following trauma or surgery. The comprehensive range of conditions treated includes everything from ingrown toenails and bunions to sprains and fractures to diabetic foot care. In addition to expert treatment using the latest techniques and technologies available, we are dedicated to palliative and preventive foot care to ensure that our patients’ feet remain healthy and strong throughout their lives.

Highlighted Conditions

Fractures – A fracture is a break in a bone. It may be a crack in the bone (a stress fracture) or a complete break; the bones may shift out of place or break the skin. Fractures in the bones of the foot and ankle cause a variety of symptoms and require different treatments depending on the location and severity of the break, as well as the patient’s overall health.

Digits (toes/phalanges) and metatarsals (long bones of the forefoot) - There are many different kinds of fractures that can happen to the bones of the forefoot and toes. They are painful but often heal without the need for surgery. The metatarsals are prone to stress fractures, or cracks in the bone. These are usually related to a recent increase or change in activity. The fifth metatarsal below the small toe may fracture if it is landed on badly or if the ligament of a twisted ankle pulls off a piece of the bone. Symptoms of a toe or metatarsal fracture include pain that gets worse when walking; swelling; and sometimes bruising.

Lisfranc joint (midfoot) – Often caused by dropping something heavy on the top of the foot or by falling after catching the foot in a hole. Symptoms are similar to a sprain and include swelling and pain at the top of the foot; bruising; possible inability to bear weight; and pain when moving the foot while the ankle is held steady. If you think you have a sprain and it does not improve with rest and ice after one to two days, you may have a Lisfranc joint fracture and should see a doctor to prevent further injury.

Calcaneus (heel) – Usually the result of an automobile accident or fall from a great height. Symptoms include pain on the outside of the ankle or under the heel; inability to bear weight; swelling and stiffness. May be accompanied by back or knee injury due to the amount of force required to break the heel bone.

Ankle – Like severely sprained ankles, broken ankles are often caused by a fall, injury or car accident. Symptoms that one or more of the three bones that make up the ankle may be fractured are: severe pain in the ankle; swelling; bruising; tenderness; inability to bear weight; and deformity of the joint. May be accompanied by dislocation or ligament damage (sprain).

Hip Replacement Surgery

Hip Replacement Surgery

The hip is a “ball-and-socket” joint where the “ball” at the top of the thigh bone (femur) fits inside the “socket” of the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip become diseased or damaged, the joint can stiffen and be very painful.

While many hip conditions can be treated through conservative methods, surgery is often needed because of the excessive weight placed on the joint while walking, standing and performing other regular activities.

Highlighted Condition

Hip Fractures A hip fracture is a break in the top of the femur (thighbone) where the bone angles toward the hip joint. If the break occurs within two inches of the joint, it is called a femoral neck fracture. If it occurs between two and four inches from the joint, it is known as an intertrochanteric fracture. (A break further down the bone is classified as a broken femur rather than a broken hip.) Femoral neck fractures require more extensive surgery.

Hip fractures usually make it too painful for the person to stand. The leg may turn outward or shorten. They generally require hospitalization and surgical repair.

A person’s risk for suffering a hip fracture increases if he or she is over 65, female, or small-boned; has a family history of hip fractures; has osteoporosis or low calcium, which leads to bone weakness; smokes or uses alcohol excessively; is physically or mentally impaired; or takes medications that cause weakness or dizziness. Hip fractures are a common and serious problem for the elderly, for whom a simple fall in the home may be enough to break the bone.

Labral Tears The hip socket, or acetabulum, is covered with a layer of cartilage called the labrum that cushions and deepens the socket to help stabilize the joint. The labrum may tear due to a traumatic injury (e.g. hip dislocation), repetitive movement (e.g. twisting or pivoting, such as in golf) or tissue degeneration (e.g. osteoarthritis or hip impingement). Sometimes, a labral tear causes no symptoms and doesn’t require treatment. However, tears may cause pain in the hip as well as stiffness, limited motion, and a sense that the joint is locking, clicking or catching.

Treatments and Procedures

Arthroscopy

 Hip arthroscopy is a minimally invasive procedure used to diagnose and treat a wide range of conditions affecting the hip joint. This procedure can be used to confirm the diagnosis of various imaging procedures, such as X-rays and MRIs, as it provides your doctor with a three-dimensional, real time imaging of the affected area, allowing for the most accurate diagnostic results. If damage or abnormalities are detected during the diagnostic procedure, repairs can often be made during the same procedure, offering patients many advantages over traditional surgery.

Arthroscopic techniques can often be used to treat conditions such as:

• Labral tear
• Loose bodies
• Snagging hip syndrome
• Cartilage damage
• Arthritis

During the hip arthroscopy procedure, your surgeon will make a small incision near the affected area of the hip and insert an arthroscope, a long flexible tube with a camera on the end that displays images of the inside of the hip joint to detect any damage. If damage is detected, it can be repaired during the same procedure by inserting surgical instruments through a few other incisions. Your surgeon can replace damaged cartilage, join together torn ends, remove loose bodies or realign the joint to minimize pain and inflammation.

Hip Fracture Repair A hip fracture involves a break in the top of the femur when the bone angles toward the hip joint. Hip fractures are especially common in older patients and those with osteoporosis. They are usually extremely painful and require surgical repair to relieve pain and restore proper functioning.

During hip fracture surgery, an incision is made over the affected area and the bones are aligned back in place. The bones are often held in place with metal pins, screws, rods or plates while they heal, which may or may not be removed later on. The incision is then closed with sutures or staples. This procedure usually takes two to four hours to perform.

Total Hip Replacement Hip replacement is usually a last resort treatment for patients with severe hip pain whose daily lives are affected by the pain, including those with arthritis, fractures, bone death or other conditions. In this procedure, the diseased bone and cartilage are replaced with a metal ball and plastic cup.

The artificial joint, called a prosthesis, may be cemented in place, may be cementless, or may be a hybrid of both. The prosthetic devices provide pain relief and restored function for 25 years or longer in most cases.

Shoulder,Elbow & Hand Replacement Surgery

Shoulder

The shoulder is a “ball-and-socket” joint made up of the upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle). This joint is the most flexible one in the body and allows for a full range of motion, but also makes the shoulder a common source of injury and instability.

Some of the most common shoulder conditions include:

• Bursitis
• Tendonitis
• Impingement
• Rotator cuff tear
• Instability
• Fractures
• Osteoarthritis
• Labral Tear
• Frozen Shoulder

While many of these conditions can be effectively managed through nonsurgical techniques, surgery is often needed to thoroughly correct the condition and allow patients to maintain an active and healthy life.

Highlighted Conditions

 Fracture: A fracture is a partial or complete crack through a bone. It is usually caused by an impact injury such as a direct blow or a fall, and can result in severe pain and limited movement. Shoulder fractures may involve the clavicle (collarbone), proximal humerus (top of the arm bone), and scapula (shoulder blade). Other bones and soft tissues may be affected as well.

Frozen Shoulder: also known as adhesive capsulitis, frozen shoulder is a common condition that causes pain and stiffness in the shoulder as a result of a tightening or thickening of the capsule that protects the structures of the shoulder. Although the specific cause of this condition is not known, it most often occurs after recent immobilization of the joint or as a complication of diabetes. Frozen shoulder most often affects patients between the ages of 40 and 60.

Elbow

The elbow is a complex joint that consists of the upper arm bone (humerus) and one of the lower arm bones (ulna) connected by a hinge, or a joint that only moves in one direction. Although not protected by muscle or fat like most other joints, the elbow is one of the most important joints in the body, as it allows the arms to bend and twist.

Some of the most common elbow injuries include:

• Biceps tendonitis
• Dislocation
• Bursitis
• Biceps tendon rupture
• Epicondylitis
• Fractures

Many of these conditions can be treated through conservative methods, but some may require surgery to effectively relieve pain and restore function to the joint. Your doctor will decide which type of treatment is best for you after a thorough evaluation of your condition.

Highlighted Conditions

 CityTennis Elbow: also known as lateral epicondylitis, tennis elbow is an elbow injury that occurs as a result of overuse, most commonly from playing tennis. The pain associated with this condition affects the lateral epicondyle, the area where the forearms’ tendons connect with the bony outer portion of the elbow. While tennis elbow typically affects adults aged 30 to 50, anyone who continually stresses their wrists is at a higher risk of developing this condition.

Golfer’s Elbow: Medial epicondylitis, more commonly known as Golfer’s Elbow, is a form of tendonitis that manifests on the inner side of the elbow. It is caused by the tendon in the forearm being stressed from constant use, but is not restricted to golfers; pitchers and even those not involved in sports can develop golfer’s elbow.

Hand or Wrist

Hand surgery is a specialized type of procedure that may be performed to correct a wide range of diseases, injuries and defects that may cause symptoms and/or affect the appearance of the hand. Hand surgery can be performed for both medical and cosmetic purposes. Your hand surgery procedure will be customized in order to repair your individual condition and leave your hands looking and feeling their bests.

Because of their frequent use, the hands are a common location for injuries and degenerative disorders such as arthritis. Many people are born with birth defects of the hand as well. Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from cysts, nerve condition such as carpal tunnel syndrome, arthritis, birth defects and other problems. Hand surgery may also be performed to re-attach or reconstruct severed fingers after trauma.

our surgeons have years of experience performing a full range of hand surgery procedures, and utilize the latest techniques while doing so.

Highlighted Conditions

Carpal Tunnel Syndrome – is a common condition involving numbness, pain, tingling and instability in the wrist, hand and fingers. It occurs when pressure is put on a nerve in the wrist called the median nerve, which controls motor function in the wrist and hand. This pressure, called impingement, is most often caused by bone spurs, rheumatoid arthritis, repetitive use or injury.

Trigger finger is a condition that involves one of the fingers becoming stuck in a bent position and then rapidly straightened like the trigger of a gun. This condition is caused by a narrowing of the sheath that surrounds the tendons in the finger, and is common in people who perform repetitive gripping actions. It is also more common in women and people with diabetes. Trigger finger causes stiffness, pain and may eventually lead to an inability to completely straighten the finger.

Dupuytren’s contracture is a rare hand deformity in which knots of tissue form under the skin that can pull fingers into a bent position. This makes it difficult for the fingers to straighten and can interfere with normal hand function. Dupuytren’s contracture is not usually painful but can lead to other conditions such as plantar fibromatosis. Although the cause of this condition is not known, it may run in families and can be influenced by tobacco and alcohol use.

Wrist Tendonitis (also called deQuervain’s tendonitis or tenosynovitis) is an inflammation of the tendons that cross the wrist and attach to the thumb. If you have deQuervain’s tendonitis, it hurts to bend, extend or turn your wrist or form a fist with the thumb tucked inside. Pain is usually located in the front of the wrist and worsens with activity. Other symptoms include sensitivity to touch, limited mobility, and wrist weakness.