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Bone Cyst

Bone Cysts can be of many types. Itmay start as swelling or pain. Blood test and testing the cyst itself with scans and a peice of it will reveal its behavior. They can be treated with just injections and scarless ( laser) procedures.

A bone cyst can present as pain and swelling. Scans and Tissue biopsy will decide further course of treatment. Aneurysmsal bone cyst can be treated with sequential sclerosant injections.


Dislocation

Subtle fracture may give rise to dislocations, which may go un-noticed until there is restricted elbow movement. These dislocation can be put back in place , usually without a surgery, sometimes needing an operation.


Fractures

Accidental fall and sports injuries are very common in children. As the child is growing their fracture needs special care. A very severe looking fracture may heal with minimal intervention, and small fracture if not treated well can give rise to life long disability.

Most of the fractures are amenable to closed reduction and casting, however, physeal injuries ,intra articular and injuries around physis need special attention and intervention.


Clubfoot

Congenital Telipes equino varus

Clubfoot is a commonest bone problem in a newborn. Cure of the condition is possible if treatment is started early and completed accordingly. The treatment consists of weekly plasters and slow correction. An average of 2 -3 months is necessary for correction. Once corrected , special shoes for night time wear be given to maintain correction till 4 years of age. Earlier the treatment better the result . Best results are seen when treatment is started in first 3 months of life.

Commonest congenital orthopedic deformity. Ponseti method of Serial casting and tenotomy is currently recommended. A cosmetically normal and fully functional foot is achievable with early correction and maintenance in almost all children of CTEV. In delayed cases operative intervention can also give desired results and a painless plantigrade functional feet.


Knock Knees

Genu Valgum

The alightment of lower limbs is important in longevity of the joint. Majority are self limiting however an excessive intermalleolar distance will cause early degenerative arthritis of knee and / or other joints of lower limbs.Flat foot may also get worsned with valgus alignment of the knees. The treatment can be a single scarless screw if done in time.

This is because of abnormal growth in the inner side of thigh bone or the leg bone. Most of the cases in children get corrected on its own. If persistent can give rise to pain and early arthritis. Pain in the knee ,foot or other joints may be experienced due to the deformity. A stich-less/ keyhole procedure can be done to correct if recognized early during growth period.


Bow Legs

Genu Varum

This condition is usually a normal course of child's development. But it has to be observed if it goes out of normal range. It can be caused due to vitamin D deficiency, which can be treated with medicines alone.

Intercondylar distance is the indicator of pathological or physiological genu varum. Blounts disease is another differential diagnosis(tibia varus). Rickets is one of the causes which can be treated with oral medications. Idiopathic pathological will have to be treated with guided Growth if it crosses normal limits of alignment.


Bendy Brittle Bones

Osteogenesis Imperfecta

A rare condition where children are born with soft bones. They tend to have bone fractures more frequently then normal. As a result legs deform and children stop walking. Treatment is to strengthen bones in the form of medicines , correct abnormal angulation and avoid future fractures by putting growing rods in growing children.

Osteogenesis imperfecta is caused by faulty collagen synthesis. Hence bone strength is inferior causing multiple fractures, malunions and deformities. Resulting in non ambulation , hence weakening bones even more. Treatment is in the form of bisphosphonates and surgical intervention. Telescopic rods are locked in metaphysis, which will distract in Telescopic fashion as the child grows.

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