LIMB DEFORMITY : Lower Extremity
- Though infants can be bowlegged, a gradual resolution is expected during the first two years of life. Persistently bowlegged toddlers warrant evaluation by a pediatric orthopedist to identify potential causes and remedies.
- This case shows a 3 ½ year old with bilatteral genu varum, also called bowlegs, a classic result of Blount’s disease, which is a condition characterized by asymmetrical growth of the proximal tibial growth plate. Hemi-epiphysiodesis is a minimally invasive procedure that gradually slows the growth plate on the outer, “normal”, portion of the knee, allowing the inner, “abnormal”, portion of the growth plate to “catch-up”. This technique worked well on the patient’s left leg, but the more severely impacted right knee did not respond as well. The patient had the plates and screws removed, but required an acute correction of the right knee by osteotomy (cutting the bone). Smooth pins and a long leg cast stabilize the bones until they have healed.
LIMB DEFORMITY : Upper Extremity
- Pediatric orthopedic surgeons at Peds Ortho also treat complex congenital deformities of the arms.
- Here is an example of a forearm reconstruction in an adolescent with neurofibomatosis, a genetically inherited disorder that may affect a child’s musculoskeletal system. The outer arm bone, called the ulna, is underdeveloped and its two ends are not fused together. Initially, the ulna is surgically broken and an external fixator is applied to lengthen it. When sufficient length is achieved, a section of the patient’s fibula, the smaller of the two calf bones, is surgically transferred to bridge the gap of the defect. Several months later, the ulna is well healed and of normal size and strength.
