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Ballarat Orthopaedics & Sports Medicine
Paediatric Orthopaedics Specialists
Ballarat Orthopaedics & Sports Medicine are involved in managing a variety of childhood conditions from fracture management, serial casting of club feet, bracing hip dysplasia, fixing slipped femoral epiphyses, and knee injuries.
There are some super specialist problems such as limb length discrepancy and tumours that we need to refer to full time paediatric orthopaedic surgeons in Melbourne. We generally prefer a call or referral letter from your GP so we can ascertain if we can help.
- Clavicle Fractures
- Wrist Fractures
- Buckle Injuries of the Wrist
- Supracondylar Elbow Fracture
- Posture and Spine Care
- Brace Treatment for DDH
- Developmental Dysplasia of the Hip
- Osgood-Schlatter Disease
- Bow Legs and Knock Knees in Children
- Intoeing in Children
- Sever's Disease
- Curly Toe
- Shoes & Footwear
- Positional Talipes
- Metatarsus Adductus
Fracture of the Clavicle (collar bone)
Your child has a fractured clavicle (collar bone). The fracture generally occurs in the middle of the bone. These fractures heal well with rest and time. An arm sling should be worn for comfort for two to three weeks. Simple pain medication is often needed, and should be given regularly until comfortable. Never exceed the recommended dose.
Encourage your child to move the elbow, hand and fingers. Gentle shoulder movement can begin when the sling is removed. Most clavicle fractures are undisplaced. This means that the bone remains correctly aligned.
Children under eleven years with undisplaced clavicle bone fractures do not require follow-up with a doctor or x-ray. Children over eleven years, and those who have a displaced fracture, will be reviewed in the fracture clinic or with the GP in one week. You will be advised if your child requires additional appointments.
Fractures of the Wrist
Wrist fractures in children Wrist fractures are common injuries of childhood. There are two bones in the forearm—the radius and the ulna. One or both bones may be broken. An x-ray helps the doctor to decide how the fracture should be treated. Sometimes the bones may need to be put back into position by the doctor in the emergency department or operating theatre.
Your child will need a cast to support and protect the bones while the fracture heals. Some pain is expected in the first days after the injury. Give paracetamol (e.g. Panadol™) as directed. Rest is important. An arm sling is helpful for the first week. Elevate your child’s wrist with pillows both day and night for the first two days, then overnight.
Encourage your child to move their fingers regularly. For further important information regarding caring for your child in the cast see Orthopaedic Fact Sheet “Fractures in children: caring for your child in an arm cast”.
Buckle Injuries of the Wrist
A buckle injury of the wrist is a small area of compressed bone. The wrist may be tender, slightly swollen, and painful to move. The injury may be difficult to see on x-ray. There is no deformity. This injury is treated by wearing a removable back slab or ready-made splint which can be removed for bathing or showering. An arm sling is optional for comfort.
Pain is usually not severe and should be managed with a simple pain medication such as paracetamol (e.g. Panadol™). Give as needed following the directions on the packet, or as directed by your child’s doctor. Since these injuries are stable and heal quickly without problems, x-ray or follow-up appointment with the GP, fracture clinic or physiotherapy is usually not required.
Supracondylar Elbow Fracture (undisplaced)
Your child has a simple fracture just above the elbow. These elbow fractures require only a backslab (partial cast) and sling. The backslab and sling should be placed under loose fitting clothing, not through the sleeve (Figure 1).
The first days In the first few days there may be swelling of the elbow, hand and fingers. During this time it is important to rest as much as possible with the elbow and hand supported on pillows (elbow and hand above the heart). The sling may be removed when your child is lying down.
Encourage your child to bend and straighten the fingers regularly. Check their fingers often for movement, feeling and circulation. The elbow will be painful initially. Give a simple pain medication such as paracetamol (e.g. Panadol™) as needed following the directions on the packet, or as directed by your doctor.
Good Posture and Spine Care in Children
Developing and maintaining good posture in childhood and adolescence is important for good health. Posture in children can be influenced by a number of factors including:
- their activity levels
- their age and gender
- their self confidence
- their height and weight
- seating equipment at school and home
- the weight and size of their school bag
Brace Treatment for DDH (Developmental dysplasia of the hip)
Babies with developmental DDH are generally referred to a paediatric orthopaedic surgeon or paediatrician. The way DDH is treated depends on the child’s age and the severity of the condition.
Infants with very mild or borderline DDH may be monitored with a follow hip ultrasound and clinical examination in around six weeks.
Developmental Dysplasia of the hip (DDH)
DDH is a condition that affects the hip joint in babies and young children. The hip is a ball-and-socket type joint, formed by the round ‘head of femur’ and a cup-shaped socket (acetabulum).
The normal infant hip is not mature at birth but develops into a strong and stable joint as the child grows. In DDH the hip does not develop normally.
Osgood-Schlatter Disease is a common cause of pain in the front of the knee in late childhood and early adolescence. It is more common in boys. One or both knees may be affected.
The condition often occurs in children who are highly active, particularly in sports involving running and jumping.
Bow Legs and Knock Knees in Children
Bow legs and knock knees are a normal part of a child’s growth.
It is normal for infants to be born with bow legs. Bow legs may become more obvious in toddlers as they begin to walk. In most children the legs disappear without treatment.
Knock Knees are common in children between the ages of three and five. In most children the legs gradually straighten.
Intoeing in Children
Intoeing is when the feet turn inwards when walking. It is common in childhood and us ususally outgrown. With intoeing, children might be prone to tripping, or look awkward when walking or running.
Sever’s disease is a common cause of heel pain in childhood and early adolescence. The condition often occurs in children who are highly active, particularly in sports involving running and jumping.
Curly toes are where some the toes curl inwards when the child is standing. The third and fourth toes are the most commonly affected.The condition usually occurs in young children and often improves without treatment.
Shoes for Young Children
Most children begin to walk from around 12 – 18 months of age. For babies learning to walk, bare feet are best, so babies can feel what they touch with their feet.
Clubfoot (talipes equinovarus)
Clubfoot is a common foot deformity in newborns, affecting about 1 in 1000 babies. It may be mild or severe, and may affect one or both feet.
Positional talipes (equino-varus) is a common foot condition in newborn babies that may affect one or both feet. In positional talipes the foot rests down and inwards.
Metatarsus Adductus is a common foot condition in babies and young children. Normally, the outside border of the foot is straight. In Metatarsus Adductus, the outside border of the foot curves inwards, resulting in a bean -shaped appearance.