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Women's and Children's Hospital

Pediatric Orthopaedics

We work to provide you with a multidisciplinary team approach to address any medical, social, emotional and physical conditions. We have physicians who specialize in sports medicine, as well as variety of general pediatric orthopaedic conditions including:

Cerebral Palsy

Cerebral palsy is basically defined as a movement disorder. Children with this noncommunicable disease have typically sustained a brain injury that prevents them from using some of their muscles in a normal way. This can lead to muscle tightness and spasm, involuntary movement, disrupted mobility and impaired sight, hearing or speech. Causes of the disease include a lack of oxygen before, during or after birth, bleeding in the brain or a head trauma resulting from a birth injury.

An estimated 500,000 people in the United States have some degree of cerebral palsy, making it the top developmental disability disease in the nation. There is no cure for cerebral palsy, but physicians and specialists work with children to help them gain as much physical control of their bodies as they can to help them lead productive lives. 

Our physicians work with speech, physical and occupational therapists. An orthotist is available to prepare and adjust wheelchairs and other adaptive equipment while you wait.

Clubfoot

The goal of treatment of clubfoot is to reduce or eliminate all of the components of the deformity so the child will have a functional, mobile, and painless foot in normal position. To achieve that goal, treatment consists of serial casting on a weekly basis, surgery, and splinting. The casting is done for approximately six weeks. Immediately before casting, the foot is massaged and manipulated to stretch the contractures.

In about 90 percent of babies with clubfoot, the Achilles tendon needs to be cut. This procedure is done before the last casting. It is called a tenotomy and is done in the clinic, under a local anesthetic with a thin scalpel. Consequently, you may see a few drops of blood on the plaster. The tendon reattaches in two to three weeks as it heals.

Following surgery please notify your doctor of any of the following:

  • Any increased drainage on the cast
  • Foul smelling odors coming from inside the cast
  • If the skin at the very edge of the cast becomes very red, sore, or irritated
  • If your baby runs a fever of 38.5 C/101.3F or higher, without any explainable reason, such as cold or a virus

Scoliosis

A healthy spine supports the body, protects the spinal cord, allows flexibility and movement, and provides points of attachment for muscles and ligaments. The spine has three normal curves that form a natural "S" shape of the vertebral column. There are 33 total vertebrae that form five regions of a spinal column: seven cervical, 12 thoracic, five lumbar, five fused vertebrae (sacrum), and four smaller fused vertebrae (coccyx). The "S" shape occurs as a child develops into an upright position. During growth and development, the cervical and lumbar vertebrae form a posterior curved-in appearance, while developing thoracic vertebrae form a posterior curved-out appearance.

When the spine develops in an abnormal lateral position, the curve is termed scoliosis. True scoliosis is diagnosed when the lateral curve is greater than 10 degrees. Four types are identified:

  • Idiopathic Scoliosis
  • Congenital Scoliosis (infantile idiopathic)
  • Neuromuscular Scoliosis
  • Degenerative Scoliosis

Treatment options include observation, bracing and surgery.

Skeletal Dysplasia

Skeletal dysplasias are a group of genetic disorders characterized by short stature and frequently associated with a range of orthopaedic problems. Many children with skeletal dysplasias have a variety of medical and social concerns that cannot adequately be addressed by single visits with a pediatrician or internist. To meet their more complex needs, these children require ongoing coordinated treatment by specialists in the field. For this reason, the Missouri Skeletal Dysplasia Clinic at MU Children's Hospital offers patients a unique opportunity to have a comprehensive assessment performed by a variety of specialists.

Our multidisciplinary approach provides a forum for diagnosis, prevention and treatment. Most patients who attend the Missouri Skeletal Dysplasia Clinic will be seen on a regular basis, depending on individual needs.

Children are seen by health-care providers from a variety of disciplines, such as genetics, orthopaedics, radiology, nutrition, nursing, physical therapy and occupational therapy.

Tips For Your Visit

  • Please arrive with your insurance card and prescription as provided by your physician.
  • For all visits, please wear comfortable clothing and shoes that are easy to move in.
  • If we are evaluating you for injuries or illness affecting your lower body or for walking difficulty, please bring shorts.
  • If you currently wear braces, orthotics or splints, please bring them to your visit to allow our therapist to fully evaluate you with these on.

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