Journal of Clinical Orthopaedics | Vol 7 | Issue 2 | Jul-Dec 2022 | page: 08 | Dr. Swapnil M Keny
DOI: 10.13107/jcorth.2022.v07i02.509
Author: Dr. Swapnil M Keny [1]
[1] MS, FCPS, D’Ortho, Sir H. N. Reliance Hospital, Mumbai, India.
Address of Correspondence
Dr. Swapnil M Keny,
MS, FCPS, D’Ortho, Sir H. N. Reliance Hospital, Mumbai, India.
E-mail: peadortho@gmail.com
“Children are not young adults”
The growing skeleton and the manifestations of its anomalies , poses peculiar sets of challenges for health workers treating children with orthopaedic disorders. This is especially true when such children and adolescents are seen and treated in the office of orthopaedic surgeons.
In India and across the subcontinent, certain taboos, customs and tradition are further hinderances for providing appropriate and timely treatment in children.
Children and their parents are extremely apprehensive when they visit the clinics of physicians. The first job of a physician then is to put the child and parents at ease. The Clinic decor, the demeanour of the medical and nursing staff and a friendly environment puts the child at ease and helps perform a thorough examination or procedures if need be.
It is preferable that the child be lured with a some form of a distraction like music, toys or even child friendly edibles so that a thorough clinical examination may be performed or a out patient procedure can be done.
The radiographs of children may appear different from that of adults. One needs to aware of the ossification process during the attainment of skeletal maturity so that a physiological change is not interpreted as pathology and vice versa.
Applying a cast in a child can turn our to be a Herculean task at times. It is extremely important that every member of the clinic team performs their jobs optimally, whether it be restraining, distracting the child or helping the physician with the procedure.
Certain disorders and deformities are peculiar to children. Diagnosing these deformities with a relevant investigation, keeping a diligent follow up and managing them timely are key determinants to successful treatment.
Children come in all shapes and sizes. Also no two children of the same age are alike. One needs to modulate the methods of examination and treatment so that a tailored regime for a specific child may be designed.
Finally, children with neurological, neuromuscular and muscular disorders have their own sets of challenges. Managing them on out patient basis needs patience and perseverance which can only come with experience.
To summarise, children are not young adults. The peculiarities of disorders in the immature skeleton need to be understood, diagnosed, treated and rehabilitated optimally.
Dr. Swapnil M Keny.
How to Cite this article: Keny S. “Children are not young adults”. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):08.
http://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.png00editor.jcorthhttp://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.pngeditor.jcorth2022-12-10 10:20:542023-01-03 15:56:17Children are not young adults
[1] Paediatric Orthopaedic Surgeon, Holy Spirit Hospital, Dr RN Cooper Hospital & HBT Medical College, Mumbai,
India.
Address of Correspondence
Dr. Atul Bhaskar,
Paediatric Orthopaedic Surgeon, Holy Spirit Hospital, Dr RN Cooper Hospital & HBT Medical College, Mumbai,
India.
E-mail: arb_25@yahoo.com
Abstract
Toe walking pattern of gait is often seen in toddlers and can persist into early childhood. A detailed assessment is warranted in children that presents after 5 years of age with persistent TW. Treatment varies from simple reassurance and physiotherapy to orthotics, casting and sometimes surgery. Prognosis of surgery is good in select cases.
Keywords: Toe Walking, Idiopathic, Neurology, Treatment
References
Sala DA, Shulman LH, Kennedy RF, Grant AD, Chu M. Idiopathic toe-walking: Areview. Dev Med Child Neurol
1999;41:846-8.
van Kuijk AA, Kosters R, Vugts M, Geurts AC. Treatment for idiopathic toe walking: A systematic. review of the literature. J Rehabil Med 2014;46:945-57.
Engström P, Tedroff K. The prevalence and course of idiopathic toe-walking in 5-year-old children. Pediatrics 2012;130:279-84.
How to Cite this article: Bhaskar A. Toe Walking in Children. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):09-11.
http://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.png00editor.jcorthhttp://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.pngeditor.jcorth2022-12-10 10:10:422023-01-03 16:00:48Toe Walking in Children
[1] Department of Paediatric Orthopaedics, BJ Wadia Hospital, Mumbai, Maharashtra, India,
[2] Consultant Paediatric Orthopaedic Surgeon, Agashe Hospital, BJ Wadia Hospital and SRCC Children’s Hospital,
Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Raja Ganesh Rayudu,
Dr. D. Y. Patil University-School of Medicine, Navi Mumbai, Maharashtra, India.
E-mail: rajaganesh70@gmail.com
Abstract
Pulled elbow is one of the commonest clinical conditions encountered by the Paediatric orthopaedic surgeon. It is primarily due to axial force applied to a semi-prone forearm which leads to proximal radio-ulnar joint dislocation. Diagnosis is usually clinical and radiographs are rarely needed. Reduction maneuvers include the Traction-supination and traction-hyperpronation method and almost always cause immediate pain relief and return to function.
Hanes L, McLaughlin R, Ornstein AE. Suspected radial head subluxation in infants: The Need for radiologic evaluation. Pediatr Emerg Care 2021;37:e58-9.
Krul M, van der Wouden JC, Kruithof EJ, van Suijlekom-Smit LW, Koes BW. Manipulative interventions for reducing pulled elbow in young children. Cochrane Database SystRev 2017;7:CD007759.
Guzel M, Salt O, Demir MT, Akdemir HU, Durukan P, Yalcin A. Comparison of hyperpronation and supination-flexion techniques in children presented to emergency department with painful pronation. Niger J Clin Pract 2014;17:201-4.
Schunk JF. Radial head subluxation: Epidemiology and treatment of 87 episodes. Ann Emerg Med 1990;19:1019-23.
Teach SJ, Schutzman SA. Prospective study of recurrent radial head subluxation. Arch Pediatr Adolesc Med 1996;150:164-6.
Quan L, Marcuse EK. The epidemiology and treatment of radial head subluxation. Am J Dis Child 1985;139:1194-7.
Kosuwon WE, Mahaisavariya BA, Saengnipanthkul SU, Laupattarakasem WI, Jirawipoolwon PO. Ultrasonography of pulled elbow. J Bone Joint Surg 1993;75:421-2.
Pring M, Wenger D, Rang M. Elbow-proximal radius and ulna. In: Rang M, Wenger DR, Pring ME, editors. Rang’s Children’s Fractures. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005. p. 119.
How to Cite this article: Shah S, Agashe M. Managing a Pulled Elbow in the Clinic. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):12-14.
http://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.png00editor.jcorthhttp://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.pngeditor.jcorth2022-12-10 10:00:302023-01-03 17:07:35Managing a Pulled Elbow in the Clinic
[1] Consultant Orthopedic Surgeon, Department of Orthopedics, Seth V.C. Gandhi & M. A Vora Municipal General
Rajawadi Hospital, Mumbai, India.
Address of Correspondence
Dr. Chintan Doshi,
1304, Building No 92, B wing, Road No 13, Tilaknagar, Chembur West, Mumbai 400089, India.
E-mail: drchintandoshi@gmail.com
Abstract
Upper limb fractures are common in pediatric population. Most of these injuries need application of cast as a routine procedure. The purpose of this review is to discuss the art of applying a well moulded upper limb cast in children in order to get excellent outcome. Material to be selected for cast application depends on the fracture configuration, requirement for moulding, and other physical properties of the cast required for particular patient. A well –moulded cast should be applied in order to prevent further fracture displacement. It is important to understand and maintain certain radiographic indices in order to ensure a good outcome from casting technique. Preventing cast related complications like wet cast, skin complication, compartment syndrome, thermal injuries, and cast syndrome are important consideration when taking care of the cast. Patient education is one of the most important factor in ensuring proper cast maintenance.
1. Halanski M, Noonan KJ. Cast and splint immobilization: complications. J Am Acad Orthop Surg. 2008;16:30–40.
2. Iltar S, Alemdaroğlu KB, Say F, Aydoğan NH. The value of the three-point index in predicting redisplacement of diaphyseal fractures of the forearm in children. Bone Joint J. 2013;95-B:563–567. .
3. Wolff CR, James P. The prevention of skin excoriation under children’s hip spica casts using the goretex pantaloon. J Pediatr Orthop. 1995;15:386–388.
4. Webb GR, Galpin RD, Armstrong DG. Comparison of short and long arm plaster casts for displaced fractures in the distal third of the forearm in children. J Bone Joint Surg Am. 2006;88:9–17.
5. Chess DG, Hyndman JC, Leahey JL, Brown DC, Sinclair AM. Short arm plaster cast for distal pediatric forearm fractures. J Pediatr Orthop. 1994;14:211–213.
6. Bhatia M, Housden PH. Redisplacement of paediatric forearm fractures: Role of plaster moulding and padding. Injury. 2006 Mar 1;37(3):259-68.
7. Malviya A, Tsintzas D, Mahawar K, Bache CE, Glithero PR. Gap index: a good predictor of failure of plaster cast in distal third radius fractures. Journal of Pediatric Orthopaedics B. 2007 Jan 1;16(1):48-52.
8. Edmonds EW, Capelo RM, Stearns P, Bastrom TP, Wallace CD, Newton PO. Predicting initial treatment failure of
fiberglass casts in pediatric distal radius fractures: utility of the second metacarpal-radius angle. J Child Orthop. 2009;3:375–381.
How to Cite this article: Doshi C. The magic of moulding – Applying upper limb cast in a child. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):15-17.
http://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.png00editor.jcorthhttp://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.pngeditor.jcorth2022-12-10 09:55:182023-01-03 17:10:46The magic of moulding - Applying upper limb cast in a child
Address of Correspondence
Dr. Avi Shah,
Consultant Paediatric Orthopaedics, NH SRCC Children’s Hospital, Mumbai, Maharashtra, India.
E-mail: dravi.paedortho@gmail
Abstract
Calcaneal apophysitis (Sever’s Disease) is a common cause of heel pain in growing children. It’s true incidence and etiology in unknown but, recent evidence supports overuse injury as an underlying etiology. It can present as either unilateral or bilateral heel pain in active growing children or adolescents who had a history of new-onset sports activity. Diagnosis mainly relies on a thorough clinical examination with a positive squeeze test being confirmatory. Radiologic imaging may be unnecessary but can help rule out or avoid missing other problematic conditions. Treatment options are mainly conservative and include rest, medications, therapy, or orthosis. Educating parents and coaches is pivotal for the prevention of these self-limiting conditions in young athletes. Evidence suggests a return to sports in most in a few weeks to months after appropriate care.
Keywords: Sever disease, heel pain, calcaneal apophysitis, overuse injury
References
Fares MY, Salhab HA, Khachfe HH, Fares J, Haidar R, Musharrafieh U. Sever’s disease of the pediatric population: Clinical, pathologic, and therapeutic considerations. Clin Med Res 2021;19:132-7.
Howard R. Diagnosing and treating sever’s disease in children. Emerg Nurse 2014;22:28-30.
Sever JW. Apophysis of oscalcis. NY State J Med 1912;95:1025.
Wiegerinck JI, Yntema C, Brouwer HJ, Struijs PA. Incidence of calcaneal apophysitis in the general population. Eur J Pediatr 2014;173:677-9.
Hosny GA, Al-Ashhab MI, Moeselhy MA, Abdrabboh MM. Current concept review of Sever’s disease in paediatric age group. Benha J Appl Sci 2021;6:297-303.
Rodríguez-Sanz D, Becerro-de-Bengoa-Vallejo R, López-López D, Calvo-Lobo C, Martínez-Jiménez EM, Perez-Boal E, et al. Slowvelocity of the center of pressure and high heel pressures may increase the risk of Sever’s disease: Acasecontrol study. BMC Pediatr 2018;18:357.
Kose O, Celiktas M, Yigit S, Kisin B. Can we make a diagnosis with radiographic examination alone in calcaneal apophysitis (Sever’s disease)? J Pediatr Orthop B 2010;19:396-8.
James AM, Williams CM, Haines TP. Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (Sever’s disease): A systematic review. J Foot Ankle Res 2013;6:16.
White RL. Ketoprofen gel as an adjunct to physical therapist management of a child with Sever disease. Phys Ther 2006;86:424-33.
McHugh MP, Cosgrave CH. To stretch or not to stretch: The role of stretching in injury prevention and performance. Scand J Med Sci Sports 2010;20:169-81.
Kase K, Walllis J, Kase T. Clinical Therapeutic Applications of the Kinesio Taping Method. Albuquerque, NM: Kinesio; 2003.
Hunt GC, Stowell T, Alnwick GM, Evans S. Arch taping as a symptomatic treatment in patients with Sever’s disease: A multiple case series. Foot 2007;17:178-83.
Kuyucu E, Gülenç B, Biçer H, Erdil M. Assessment of the kinesiotherapy’s efficacy in male athletes with calcaneal apophysitis. J Orthop Surg Res 2017;12:146.
Perhamre S, Janson S, Norlin R, Klässbo M. Sever’s injury: Treatment with insoles provides effective pain relief. Scand J Med Sci Sports 2011;21:819-23.
Wiegerinck JI, Zwiers R, Sierevelt IN, van Weert HC, van Dijk CN, Struijs PA. Treatment of calcaneal apophysitis:
Wait and see versus orthotic device versus physical therapy: A pragmatic therapeutic randomized clinical trial. J
Pediatr Orthop 2016;36:152-7.
Alfaro-Santafé J, Gómez-Bernal A, Lanuza-Cerzócimo C, Alfaro-Santafé JV, Pérez-Morcillo A, Almenar-Arasanz AJ. Effectiveness of custom-made foot orthosesvs. heel-lifts in children with calcaneal apophysitis (Sever’s disease): A CONSORT-compliant randomized trial. Children (Basel).2021;8:963.
Belikan P, Färber LC, Abel F, Nowak TE, Drees P, Mattyasovszky SG. Incidence of calcaneal apophysitis (Sever’s disease) and return-to-play in adolescent athletes of a German youth soccer academy: A retrospective study of 10 years. J Orthop Surg Res 2022;17:83.
How to Cite this article: Gupta K, Shah A. “Severs Disease” – Manifestations and Management. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):18-21.
Author: Prajakta Bhide [1], Sandeep V Vaidya [1,2]
[1] Department of Orthopaedics, Pinnacle Orthocentre Hospital, Thane, Maharashtra, India,
[2] Department of Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Sandeep V Vaidya,
Department of Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
E-mail: drsvvaidya@gmail.com
Abstract
Intoed and out-toed gait in children can occur due to foot deformities or torsional alignment of the femur and/or tibia. In most cases, these deformities are physiological and resolve with age. Physical examination consists of assessment of rotational profile of the lower limb which includes foot progression angle, torsional alignment of the femur and tibia, and foot shape. Few cases may be due to underlying pathological conditions which need to be identified and treated.
Staheli LT. Lower positional deformity in infants and children: A review. J Pediatr Orthop 1990;10:559-63.
Noonan B, Cooper T, Chau M, Albersheim M, Arendt EA, Tompkins M. Rotational deformity-when and how to address femoral anteversion and tibial torsion. Clin Sports Med 2022;41:27-46.
Rethlefsen SA, Kay RM. Transverse plane gait problems in children with cerebral palsy. J Pediatr Orthop 2013;33:422-30.
Swaroop VT, Dias L. Orthopedic management of spina bifida. Part I: hip, knee, and rotational deformities. J Child Orthop 2009;3:441-9.
How to Cite this article: Bhide P, Vaidya SV. In Toeing and Out Toeing in Children. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):22-26.
http://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.png00editor.jcorthhttp://jcorth.com/wp-content/uploads/2016/10/BOS-LOGO.pngeditor.jcorth2022-12-10 09:30:402023-01-03 17:18:35In Toeing and Out Toeing in Children
Children are not young adults
/in Vol 7 | Issue 2 | Jul-Dec 2022 /by editor.jcorthJournal of Clinical Orthopaedics | Vol 7 | Issue 2 | Jul-Dec 2022 | page: 08 | Dr. Swapnil M Keny
DOI: 10.13107/jcorth.2022.v07i02.509
Author: Dr. Swapnil M Keny [1]
[1] MS, FCPS, D’Ortho, Sir H. N. Reliance Hospital, Mumbai, India.
Address of Correspondence
Dr. Swapnil M Keny,
MS, FCPS, D’Ortho, Sir H. N. Reliance Hospital, Mumbai, India.
E-mail: peadortho@gmail.com
“Children are not young adults”
The growing skeleton and the manifestations of its anomalies , poses peculiar sets of challenges for health workers treating children with orthopaedic disorders. This is especially true when such children and adolescents are seen and treated in the office of orthopaedic surgeons.
In India and across the subcontinent, certain taboos, customs and tradition are further hinderances for providing appropriate and timely treatment in children.
Children and their parents are extremely apprehensive when they visit the clinics of physicians. The first job of a physician then is to put the child and parents at ease. The Clinic decor, the demeanour of the medical and nursing staff and a friendly environment puts the child at ease and helps perform a thorough examination or procedures if need be.
It is preferable that the child be lured with a some form of a distraction like music, toys or even child friendly edibles so that a thorough clinical examination may be performed or a out patient procedure can be done.
The radiographs of children may appear different from that of adults. One needs to aware of the ossification process during the attainment of skeletal maturity so that a physiological change is not interpreted as pathology and vice versa.
Applying a cast in a child can turn our to be a Herculean task at times. It is extremely important that every member of the clinic team performs their jobs optimally, whether it be restraining, distracting the child or helping the physician with the procedure.
Certain disorders and deformities are peculiar to children. Diagnosing these deformities with a relevant investigation, keeping a diligent follow up and managing them timely are key determinants to successful treatment.
Children come in all shapes and sizes. Also no two children of the same age are alike. One needs to modulate the methods of examination and treatment so that a tailored regime for a specific child may be designed.
Finally, children with neurological, neuromuscular and muscular disorders have their own sets of challenges. Managing them on out patient basis needs patience and perseverance which can only come with experience.
To summarise, children are not young adults. The peculiarities of disorders in the immature skeleton need to be understood, diagnosed, treated and rehabilitated optimally.
Dr. Swapnil M Keny.
(Abstract Full Text HTML) (Download PDF)
Toe Walking in Children
/in Vol 7 | Issue 2 | Jul-Dec 2022 /by editor.jcorthJournal of Clinical Orthopaedics | Vol 7 | Issue 2 | Jul-Dec 2022 | page: 09-11 | Atul Bhaskar
DOI: 10.13107/jcorth.2022.v07i02.511
Author: Dr. Atul Bhaskar [1]
[1] Paediatric Orthopaedic Surgeon, Holy Spirit Hospital, Dr RN Cooper Hospital & HBT Medical College, Mumbai,
India.
Address of Correspondence
Dr. Atul Bhaskar,
Paediatric Orthopaedic Surgeon, Holy Spirit Hospital, Dr RN Cooper Hospital & HBT Medical College, Mumbai,
India.
E-mail: arb_25@yahoo.com
Abstract
Toe walking pattern of gait is often seen in toddlers and can persist into early childhood. A detailed assessment is warranted in children that presents after 5 years of age with persistent TW. Treatment varies from simple reassurance and physiotherapy to orthotics, casting and sometimes surgery. Prognosis of surgery is good in select cases.
Keywords: Toe Walking, Idiopathic, Neurology, Treatment
References
1999;41:846-8.
(Abstract Full Text HTML) (Download PDF)
Managing a Pulled Elbow in the Clinic
/in Vol 7 | Issue 2 | Jul-Dec 2022 /by editor.jcorthJournal of Clinical Orthopaedics | Vol 7 | Issue 2 | Jul-Dec 2022 | page: 12-14 | Shalin Shah, Mandar Agashe
DOI: 10.13107/jcorth.2022.v07i02.513
Author: Shalin Shah [1], Mandar Agashe [2]
[1] Department of Paediatric Orthopaedics, BJ Wadia Hospital, Mumbai, Maharashtra, India,
[2] Consultant Paediatric Orthopaedic Surgeon, Agashe Hospital, BJ Wadia Hospital and SRCC Children’s Hospital,
Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Raja Ganesh Rayudu,
Dr. D. Y. Patil University-School of Medicine, Navi Mumbai, Maharashtra, India.
E-mail: rajaganesh70@gmail.com
Abstract
Pulled elbow is one of the commonest clinical conditions encountered by the Paediatric orthopaedic surgeon. It is primarily due to axial force applied to a semi-prone forearm which leads to proximal radio-ulnar joint dislocation. Diagnosis is usually clinical and radiographs are rarely needed. Reduction maneuvers include the Traction-supination and traction-hyperpronation method and almost always cause immediate pain relief and return to function.
Keywords: Pulled elbow, Proximal radioulnar joint dislocation, Supination maneuver, Hyper-pronation maneuver.
References
(Abstract Full Text HTML) (Download PDF)
The magic of moulding – Applying upper limb cast in a child
/in Vol 7 | Issue 2 | Jul-Dec 2022 /by editor.jcorthJournal of Clinical Orthopaedics | Vol 7 | Issue 2 | Jul-Dec 2022 | page: 15-17 | Chintan Doshi
DOI: 10.13107/jcorth.2022.v07i02.515
Author: Chintan Doshi [1]
[1] Consultant Orthopedic Surgeon, Department of Orthopedics, Seth V.C. Gandhi & M. A Vora Municipal General
Rajawadi Hospital, Mumbai, India.
Address of Correspondence
Dr. Chintan Doshi,
1304, Building No 92, B wing, Road No 13, Tilaknagar, Chembur West, Mumbai 400089, India.
E-mail: drchintandoshi@gmail.com
Abstract
Upper limb fractures are common in pediatric population. Most of these injuries need application of cast as a routine procedure. The purpose of this review is to discuss the art of applying a well moulded upper limb cast in children in order to get excellent outcome. Material to be selected for cast application depends on the fracture configuration, requirement for moulding, and other physical properties of the cast required for particular patient. A well –moulded cast should be applied in order to prevent further fracture displacement. It is important to understand and maintain certain radiographic indices in order to ensure a good outcome from casting technique. Preventing cast related complications like wet cast, skin complication, compartment syndrome, thermal injuries, and cast syndrome are important consideration when taking care of the cast. Patient education is one of the most important factor in ensuring proper cast maintenance.
Keywords: Pediatric fractures, Upperlimb cast, Casting, Cast technique, Cast complication
References
1. Halanski M, Noonan KJ. Cast and splint immobilization: complications. J Am Acad Orthop Surg. 2008;16:30–40.
2. Iltar S, Alemdaroğlu KB, Say F, Aydoğan NH. The value of the three-point index in predicting redisplacement of diaphyseal fractures of the forearm in children. Bone Joint J. 2013;95-B:563–567. .
3. Wolff CR, James P. The prevention of skin excoriation under children’s hip spica casts using the goretex pantaloon. J Pediatr Orthop. 1995;15:386–388.
4. Webb GR, Galpin RD, Armstrong DG. Comparison of short and long arm plaster casts for displaced fractures in the distal third of the forearm in children. J Bone Joint Surg Am. 2006;88:9–17.
5. Chess DG, Hyndman JC, Leahey JL, Brown DC, Sinclair AM. Short arm plaster cast for distal pediatric forearm fractures. J Pediatr Orthop. 1994;14:211–213.
6. Bhatia M, Housden PH. Redisplacement of paediatric forearm fractures: Role of plaster moulding and padding. Injury. 2006 Mar 1;37(3):259-68.
7. Malviya A, Tsintzas D, Mahawar K, Bache CE, Glithero PR. Gap index: a good predictor of failure of plaster cast in distal third radius fractures. Journal of Pediatric Orthopaedics B. 2007 Jan 1;16(1):48-52.
8. Edmonds EW, Capelo RM, Stearns P, Bastrom TP, Wallace CD, Newton PO. Predicting initial treatment failure of
fiberglass casts in pediatric distal radius fractures: utility of the second metacarpal-radius angle. J Child Orthop. 2009;3:375–381.
(Abstract Full Text HTML) (Download PDF)
“Severs Disease” – Manifestations and Management
/in Vol 7 | Issue 2 | Jul-Dec 2022 /by editor.jcorthJournal of Clinical Orthopaedics | Vol 7 | Issue 2 | Jul-Dec 2022 | page: 18-21 | Khyati Gupta [1], Avi Shah [2]
DOI: 10.13107/jcorth.2022.v07i02.517
Author: Khyati Gupta [1], Avi Shah [2]
[1] Fellow in Paediatric Orthopaedics, NH SRCC Children’s Hospital, Mumbai, Maharashtra, India.
[2] Consultant Paediatric Orthopaedics, NH SRCC Children’s Hospital, Mumbai, Maharashtra, India..
Address of Correspondence
Dr. Avi Shah,
Consultant Paediatric Orthopaedics, NH SRCC Children’s Hospital, Mumbai, Maharashtra, India.
E-mail: dravi.paedortho@gmail
Abstract
Calcaneal apophysitis (Sever’s Disease) is a common cause of heel pain in growing children. It’s true incidence and etiology in unknown but, recent evidence supports overuse injury as an underlying etiology. It can present as either unilateral or bilateral heel pain in active growing children or adolescents who had a history of new-onset sports activity. Diagnosis mainly relies on a thorough clinical examination with a positive squeeze test being confirmatory. Radiologic imaging may be unnecessary but can help rule out or avoid missing other problematic conditions. Treatment options are mainly conservative and include rest, medications, therapy, or orthosis. Educating parents and coaches is pivotal for the prevention of these self-limiting conditions in young athletes. Evidence suggests a return to sports in most in a few weeks to months after appropriate care.
Keywords: Sever disease, heel pain, calcaneal apophysitis, overuse injury
References
Wait and see versus orthotic device versus physical therapy: A pragmatic therapeutic randomized clinical trial. J
Pediatr Orthop 2016;36:152-7.
(Abstract Full Text HTML) (Download PDF)
In Toeing and Out Toeing in Children
/in Vol 7 | Issue 2 | Jul-Dec 2022 /by editor.jcorthJournal of Clinical Orthopaedics | Vol 7 | Issue 2 | Jul-Dec 2022 | page: 22-26 | Prajakta Bhide [1], Sandeep V Vaidya [1,2]
DOI: 10.13107/jcorth.2022.v07i02.519
Author: Prajakta Bhide [1], Sandeep V Vaidya [1,2]
[1] Department of Orthopaedics, Pinnacle Orthocentre Hospital, Thane, Maharashtra, India,
[2] Department of Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Sandeep V Vaidya,
Department of Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
E-mail: drsvvaidya@gmail.com
Abstract
Intoed and out-toed gait in children can occur due to foot deformities or torsional alignment of the femur and/or tibia. In most cases, these deformities are physiological and resolve with age. Physical examination consists of assessment of rotational profile of the lower limb which includes foot progression angle, torsional alignment of the femur and tibia, and foot shape. Few cases may be due to underlying pathological conditions which need to be identified and treated.
Keywords: in-toeing, out- toeing, torsional profile
References
(Abstract Full Text HTML) (Download PDF)