Our terminology
Cerebral palsy
Cerebral palsy is a condition that affects posture, movement and
coordination. It is caused by damage to the brain before, during or
after birth. Cerebral palsy is not a progressive disease; however,
the effects have been known to change over time. Children with
cerebral palsy often have an irregular posture; their bodies may be
either very floppy or very stiff, and this may lead to deformities
of the spine or lower limbs over time.
Gait abnormalities
Gait abnormailities typically result from affections of nervous
and musculoskeletal systems. Abnormal gait may be caused by a
variety of conditions, the commonest of which is CP, but may also
include hip dysplasia, arthritis, anatomical abnormalities, pain
and neurological conditions.
Developmental dysplasia of the hip
Developmental dysplasia of the hip (DDH) describes a variety of
conditions in which the ball and socket of the hip do not develop
properly. In the mildest forms, the socket may fail to grow deep
enough. In the more severe forms, the femoral head or ball may be
displaced completely out of the socket and be dislocated. In the
past this was known as a congenital dislocated hip (CDH). Some
babies may grow out of a mild instability without treatment, but at
the moment there is no way to tell which hips will come right on
their own. So all babies who have been diagnosed as having a hip
problem will be closely monitored. Treatment ranges from using a
Pavlik Harness (if diagnosed early), to an examination under
anaesthetic (with application of a hip spica plaster cast) or a
more extensive operation to put the ball and socket in place.
Legg-Calve-Perthes disease
Legg-Calve-Perthes disease is an age dependent condition of the
hip joint, where a loss of bone mass leads to some degree of
collapse of the hip joint, which may cause a deformity of the ball
of the femur and the surface of the hip socket. It is caused by an
interruption to the blood supply of the head of the femur close to
the hip joint. It is equivalent to adult avascular necrosis. The
goal of treatment is to avoid degenerative arthritis.
SUFE (Slipped Upper Femoral Epiphysis)
SUFE (Slipped Upper Femoral Epiphysis)Is a condition involving
the upper end of the femur (thigh bone), where the epiphyseal plate
(growth plate) is weakened and the head of the femur (ball) is
slipped downward and backward. As the hip joint functions as a ball
and socket, movement of the hip may be affected. The exact cause of
this condition is not known, although there may be a link between
increased weight and the hormones associated with puberty. Early
diagnosis is important to prevent delay in treatment and worsening
of the slip.
Skeletal dysplasia
Skeletal dysplasiasis a general term that refers to abnormal
bone and cartilage development. There are over 200 different kinds
of skeletal dysplasias, with a wide range of symptoms. The four
most common skeletal dysplasias are achondrogenesis, achondroplasia
(aka dwarfism - one of the most common forms of non-lethal skeletal
dysplasia), osteogenesis imperfecta, and thanatophoric
dysplasia.
Metatarsus adductus
Metatarsus adductusis a common foot deformity that causes the
front half of the foot, or forefoot, to turn inward. May also be
referred to as "flexible" (the foot can be straightened to a degree
by hand) or 'non-flexible' (the foot cannot be straightened by
hand). The goal of treatment is to straighten the position of the
forefoot and heel. Treatment options vary for infants, and may
include observation, stretching/manipulation of the foot, casts and
surgery.
Juvenile Hallux Valgus
Hallux valgus is an abnormally positioned big toe, in which the
joint at the base of the toe bulges outward from the inner side of
the foot and the big toe points inward (toward the smaller toes).
People commonly come to hospital because of pain, or because they
are unhappy with the way their foot/feet looks. Surgery is the
mainstay of treatment for this condition, but it is often delayed
until skeletal maturity if possible, as this decreases the chance
of the deformity recurring post operatively.
Radio-Ulnar Synostosis
Radio-Ulnar Synostosisis a term used to describe a bony or soft
tissue connection between the radius and ulna, the two bones of the
forearm. This abnormal connection may be congenital or may occur
following fracture or other trauma to the forearm. The diagnosis is
often made late in childhood or adolescence, as pain is rarely a
complaint and much of elbow flexion/extension is preserved.
Treatment recommendations are made based upon the degree of
functional loss associated with loss of forearm rotation. Treatment
ranges from surveillance of the condition to surgery.
Tarsal coalitions
Tarsal coalitionis an abnormal connection that develops between
two bones in the back of the foot (the tarsal bones). This abnormal
connection-which can be composed of bone, cartilage, or fibrous
tissue-may lead to limited motion and pain in one or both feet.
Symptoms generally do not appear until the bones begin to
mature-usually around ages 9-16, but can range from pain to
stiffness in the foot/feet. A tarsal coalition is difficult to
identify until a child's bones begin to mature, additional
diagnostic imaging tests (such as a CT scan or MRI) may also be
needed. Treatment varies from analgesia, physiotherapy, steroid
injections to surgery.
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