First orthopaedic examination of children is done by paediatricians during the general examination after birth. We scan children above one month with hip ultrasound and make a general orthopaedic examination. If the baby’s parents are suspicious of an anomaly or the paediatrician detects an orthopaedic anomaly in the first examination, the baby can be examined before one month has passed.
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Gender does not affect the age of starting to walk. It is expected that standing up with support and cruising begins by 9 to 12th months, supported walk by 12th month and independent walk by 12 to18th month.
Isolated clubfoot at birth (pes equinovarus) is seen more frequently in some races. Additionally, history of pes equinovarus in the family increases the probability of it emerging in the baby. However, genetic research on isolated pes equinovarus continues and some results have been obtained. On the other hand, pes equinovarus can accompany some other genetic diseases and such conditions require specific approach.
Length of treatment depends on the degree of flat-footedness. Generally the arch supports are used until the complaints are remedied or the shape of the foot is corrected. This can extend into adulthood.
Although posture problems can be detected as soon as the child stands up and walks, they become more apparent at ages 11-12 in girls and 13-14 in boys, where increase in height makes them more visible. Furthermore, spinal scans are made at these ages since the adolescent idiopathic scoliosis, the most common cause of spinal curvature, a presentation seen more in girls emerge in these ages.
Paediatric orthopaedists work on orthopaedic problems of children from new-born to 18 years of age.
Tiptoeing is commonly observed in children starting to walk. Without additional disorders the child, it’s a generally regressing habit. Of course a paediatric orthopaedic examination can differ. The cases where it is on one foot or when accompanied by other problems or in cases where the child cannot put heels on the floor shall raise suspicion and a paediatric orthopaedist shall be visited.
Spinal curvatures called scoliosis can emerge in children due to bone growth problems from birth, muscle or nerve system problems in the child, traumas or anomalies in organs in the abdomen or chest. Generally scoliosis seen in children emerges in adolescence and frequently the reason is not fully explained. Visiting a paediatric orthopaedist upon detecting curvature in the spine is important to reveal the reasons. Monitoring with exercise, corset practices and surgery are the options in treatment of scoliosis. Suitable option is selected based on the underlying reason.
Upon diagnosis of cerebral palsy, treatment shall be started regardless of the age of the child in order to prevent potential future restrictions. In this case, a team of paediatric neurology, paediatric orthopaedics, physiotherapy and brain surgery doctors and physiotherapists work to make the child an active individual with minimal restrictions.
Despite difficulties in our country, there a new opportunities arising every day to prevent our children from being left behind with respect to education. Schools with suitable facilities can provide education to children with CP together with children without CP, and there are special schools for children with advanced restrictions within some rehabilitation centres. Furthermore, subject to some procedures, children with severe physical restrictions can be schooled at home with teachers sent home. For further details contact Ministry of National Education and rehabilitation centres.