Pediatric Orthopedics

Children are different! This is critically important to recognize in order to successfully diagnose and treat orthopedic pathology in the skeletally immature. Even within this broad range, there are dramatic differences among the neonate, child, and adolescent subsets. It is crucial to appreciate all of the differences in their biological, psychological, social, and emotional states when treating the pediatric patient. For example, it would be unwise to ignore a young child’s activity level when treating a fracture—inadequate immobilization or cast removal too early will have disastrous end results. Recognition of this special group gave orthopedics its name. “Orthopedics” means “straight child” and alludes to the interest and time spent correcting deformities in children. These deformities can result not only from injury but also from systemic and local disease states, both congenital and acquired. Because the child is growing, these diseases produce anatomic and physiologic effects not expected in the adult. Therefore, before discussing specific entities, it would be appropriate to review the biological differences of the child’s musculoskeletal system and the influences that act on the immature skeleton.