Children are not simply small adults. They have specific and specialized needs that must be addressed in a time-sensitive manner to achieve the best results. Their "growing bones" pose different challenges than those of adults. Sometimes, what looks like a problem in a child is just a variation that the child will outgrow over time. Some common pediatric problems don't even occur in adults. As a Pediatric orthopedic surgeon, my office, supporting staff, and medical approach are focused on the unique needs of the kids and families to create a comfortable, patient-focused and family-friendly environment.
Patients diagnosed with neuromuscular conditions are at known risks for various associated orthopaedic disorders. The orthopaedic surgeon's job is to improve function, prevent deformity, guide appropriate physical therapy, manage bracing, and decrease pain. Most conditions result from a combination of muscle weakness and imbalance. Surgeons' goals are to restore this balance and minimize physical barriers. Services are often coordinated with other care providers as part of a multidisciplinary approach.
Common neurologic conditions addressed by orthopaedic surgeons include:
- Cerebral Palsy
- Muscular Dystrophy
- Spinal Muscular Atrophy
- Developmental Delay
- Metabolic Disorders
- Brain Injury
- Spina bifida
- Seizure Disorders
- Spinal Cord Injury
Families often express concern as an adolescent with a chronic condition transitions into adulthood and the subsequent transition of care from pediatric specialists to adult specialists. The adult treatment on chronic childhood diseases require an understanding of both pediatric and adult treatments of life-long conditions. This includes: Cerebral Palsy, spina bifida, muscular dystrophy, and progressive metabolic and neurologic conditions that were diagnosed in childhood.
Neurologic conditions may include a component of muscular tightness known as spasticity which can hinder function and create deformity. Our approach to the management of spasticity focuses on a multi-faceted, multidisciplinary approach including both nonoperative and operative treatments to minimize disability and maximize function.
- We coordinate closely with the patient's physical therapists, primary care providers, and neurologists.
- Prescribing and managing appropriate bracing.
- Medical treatments may include: Botox injections, Baclofen, Muscle relaxants
- Surgical treatments may include a combination of corrective muscular, tendon, and/or bone procedures.
- Baclofen pump management
In Delaware, we are fortunate to have one of the few accredited functional gait labs in the country located in Wilmington. Gait and motion analysis provides detailed technical information about how a patient moves, both normally and abnormally, identifies abnormal muscle tone and bone deformities, as well as assesses a patient's ability to control body movements. The data gathered helps physicians to understand what therapies and surgeries might be helpful.
While formal analysis is helpful, a trained physician with a discerning eye can identify a significant amount of information related to cause, diagnosis, and appropriate treatments.