Revisiting Paediatric Orthopaedics

Abstract

The meaning of the term "Orthopaedics" denotes the science of correcting deformities in children. It has since long outgrown its Paediatric boots to encompass a variety of diseases in all age groups pertaining to limbs and trunk disorders. However, its name suggests the importance of Paediatric concerns in Orthopaedics. The influence of growth and development on the musculoskeletal system, make the speciality of Paediatric Orthopaedics both interesting and unique. The interventions performed in a child usually has repercussions in adulthood, which makes a long follow-up necessary. Some clinical problems (physiological pes planus and genu varum) in children are just a variation of normal which may resolve with time. The principle of remodelling can be used judiciously in the management of a variety of traumatic disorders. Growth modulation may be used until a certain age for the correction of limb and trunk deformities.This special issue of the journal presents a vast array of disorders in Paediatric Orthopaedics ranging from scoliosis 1,2 to clubfoot. 3e5 Ahmad 1 in a review article on early onset scoliosis suggested that the cornerstone of its treatment is the facilitation of optimal conditions for lung development, thoracic growth, and spinal movement and the spinal fusion should be postponed as much as possible, at least until alveolar growth and significant chest development is completed close to puberty. Jagger et al. 2 concluded that large thoracic scoliotic curves are associated with poorer lung function but better exercise capacity is likely related to higher levels of physical conditioning.Ponseti's technique of serial plaster correction of club foot is now a well-accepted and successful method for most idiopathic clubfeet. However, in resistant and difficult cases a modification in standard technique is described to achieve good results. 3 There are thought-provoking articles on cerebral palsy, 6 pediatric hip, 7,8 trauma and tuberculosis. 9 Yadav et al. 8 in a case series concluded that the Botulinum injections are safe and effective for spasticity of upper limbs in cerebral palsy and capable of improving function without major side effects. Tuberculosis of bones and joints is still seen in the underdeveloped and developing nations. In a review article, there is an excellent overview of this problem in children, with its management strategies. 9 Besides the original research and review articles, there are several case reports in this issue, that will be of educational interest to general Orthopaedic surgeons as well. In addition to the articles on Paediatric Orthopaedics, there is a review article based on the last five-year audit of this journal, which highlights its growth. This scientometric analysis 10 also points out that a sub-speciality like pediatric Orthopaedics needs more "share in the pie" in the general Orthopaedic journals like the Journal of Clinical Orthopaedics and trauma, as there are only a handful of exclusive Paediatric Orthopaedic journals in the world. This will definitely build m...