We help children suffering from bone, joint, and muscle conditions. When children’s activities from trampolines to monkey bars end up causing musculoskeletal injuries, our pediatric orthopedics care at American Hospital Dubai helps them heal and get them back to the sport and play quickly.
American Hospital Dubai is fully committed to delivering world-class treatment for pediatric orthopedic conditions, including chronic and congenital conditions that affect the bones and muscles, by a highly specialized team of expert Pediatric Orthopedic Doctors and Pediatric Physiotherapists alongside other healthcare professionals. We are also experts in Pediatric Rehabilitation Medicine and Pediatric Orthotic Services in parallel with our Pediatric Orthopedic expertise. Our multi-disciplinary approach ensures that your child receives the best possible care throughout the treatment of their condition here at the American Hospital Dubai.
Please continue reading to learn more about Pediatric Orthopedics, the patient’s journey towards healing, and the range of services we offer at the American Hospital Dubai.
Pediatric Orthopedics is the science and practice of treating children with deformities of the bone, joints, and muscles. It is a broad specialty encompassing congenital conditions a child may be born with or conditions arising in childhood from disease or injury. Children with pediatric orthopedic conditions usually present to the doctor with pain or deformity in their limbs affecting their function and well-being.
Pediatric Orthopedics is quite distinct from adult orthopedics with very little overlap between conditions. In essence, problems affecting the bones, muscles, and joints in adults are very different to conditions affecting children. Degenerative change causing joint damage from arthritis or tendon injury/tears are not usually seen in children. Similarly, pediatric conditions such as slipped upper femoral epiphysis and Perthes disease do not arise in adulthood. It is always best to see a doctor with specific experience in managing pediatric orthopedic conditions in the first instance so that a diagnosis can be reached quickly and treatment commenced.
Investigations and treatments can be very different when comparing pediatric and adult orthopedics. Adult orthopedics mainly focuses on dealing with damaged joints and tendons with joint replacement technologies or tendon repair. In children, the emphasis is on the assessment of deformity and muscle imbalance. The Pediatric Orthopedic doctor focuses the clinical examination on whether there is an asymmetry in leg length, alignment, or muscle imbalance causing the child’s symptoms. The aims of treatment are to address the deformity and muscle imbalance through patient-specific treatment programs including physiotherapy, orthotics, and surgery to improve the comfort and function of your child.
In adults, bones, joints, and muscles may not change much over time. However, children are constantly growing producing an ever-changing landscape. Pediatric orthopedic doctors are experts in the development of children’s bones and joints and can provide the best advice on how your child’s condition will change as they grow. Many pediatric orthopedic conditions will improve over time, and the doctor can advise you on the timescale for improvement and whether treatment may be required. Some conditions may require early treatment before symptoms arise, whereas in other conditions, it will be best to treat only after symptoms arise.
Complex conditions require a lifetime treatment plan to address how the child’s condition will change over time and at what stages treatment will be required. The aim of every lifetime treatment plan is to ensure that comfort and function are optimized by the time the child reaches adulthood.
Our portfolio of successfully treating pediatric orthopedic disorders covers all pediatric orthopedic conditions including:
• Congenital hip dislocation/developmental hip dysplasia – American Hospital has focused expertise in diagnosing and treating developmental hip dysplasia using a step-wise management program beginning with the most non-invasive treatments possible to achieve the best outcome. American Hospital has an ultrasound screening program for all babies deemed to have elevated risk of hip dysplasia to diagnose the problem early when non-invasive treatments will be most successful. Our treatments include hip bracing using the Pavlik harness, arthrogram assessment, closed reduction, and surgery. American Hospital is proud to offer the most comprehensive surgical treatment for congenital hip dislocation. Single-stage hip reconstruction combines open reduction, soft tissue surgery with femoral and pelvic osteotomies to restore the natural anatomy of the hip and minimize the time your child has to spend in a plaster cast following surgery. Following surgery, most patients will not require a plaster cast for longer than 6 weeks. The risk of repeat dislocation following surgery is comparable with the best Pediatric Orthopedic Centers in the world.
• Perthes disease – The American Hospital is at the forefront of early treatment of this condition to achieve the best possible outcome. We aim for early diagnosis and tailor treatment to the specific patient by evaluating the hip with an arthrogram to determine the optimal treatment strategy. Containment surgery is offered in selected cases to minimize the risk of future hip deformity giving rise to pain and stiffness requiring hip replacement surgery. In cases that present late where head deformity has occurred, we will discuss the various treatment options available to improve the clinical outcome including physiotherapy, hip distraction/arthrodiastasis, corrective osteotomy, and acetabular shelf augmentation.
• Slipped upper femoral epiphysis – Our doctors will carefully assess your child to determine a patient-specific treatment plan based on how long the problem has been going on, how severe the slip is, and the risk of complications with or without treatment. Treatments include pinning in situ for milder slips, open surgery with osteotomies to treat severe slips, and corrective osteotomies for healed deformities.
• Clubfoot – Ponseti treatment is undertaken by our dedicated clubfoot multidisciplinary team including pediatric orthopedics, physiotherapy, and orthotics. Serial casting is undertaken to slowly correct the deformity with Achilles tendon tenotomy as a final step. Our expert Orthotic service will ensure that your child has comfortable well sized boots and bar to maintain the correction throughout infancy with input from expert physiotherapists to keep your child’s feet strong and stretchy.
• Flatfeet – Severe flatfeet can become painful in teenagers particularly if they have tight calf muscles. Non-operative treatment is always the first line with specialist physiotherapy and orthotic insoles. Surgery is reserved for teenagers with significant flatfeet that still cause discomfort when walking long distances despite physiotherapy and orthotic insoles. At American Hospital, our Pediatric orthopedic Doctors undertake biological reconstruction with osteotomies and tendon procedures to change the shape of your child’s foot to improve their comfort levels without fusing joints or using artificial implants.
• High arched (cavus) feet – these can cause problems with children walking on the outside of their feet leading to discomfort when walking long distances, ankle instability and muscle tears due to repeated ankle sprains. Our Pediatric orthopedic doctors will assess the deformity clinically and with radiographs. If there is a significant deformity causing symptoms, surgery to correct the deformity may be the best choice. We offer patient specific minimal surgery with osteotomy and tendon transfer to correct the deformity while preserving strength and flexibility.
• Equinus deformity – although many children tiptoe due to calf muscle tightness, this does not always cause symptoms. However, tiptoe walkers may progress into teenage years with tight calf muscles and discomfort with sporting activity. Physiotherapy is the best first-line treatment at the American Hospital. If there is significant deformity, lengthening of the calf muscle complex is a fairly straightforward procedure to improve ankle range of motion and discomfort from calf tightness.
• Cerebral palsy – children with cerebral palsy who are wheelchair users are at risk of progressive hip dislocation during the first decade of life which manifests slowly with slumped seating posture, difficulty washing, and dressing, future scoliosis, and eventual hip pain and stiffness. Our multi-disciplinary team at American Hospital are focused on the care of children with neurodevelopmental conditions such as cerebral palsy. Physiotherapy, rehabilitation medicine, and pediatric orthopedic doctors work together to optimize the comfort and function of children. Postural management and physiotherapy are initiated as a first-line for hip displacement with surgery reserved for progressive dislocation. Our doctors are skilled in undertaking single-stage hip reconstruction which is the gold standard treatment for hip displacement in cerebral palsy.
• Children with cerebral palsy who are able to walk using mobility aids are at risk of losing walking ability and having reduced independence as they progress into adult life. Our multi-disciplinary team focuses treatment on ensuring that walking is optimized in these children through input from physiotherapy, rehabilitation medicine, orthotics and pediatric orthopedics. American Hospital has expertise in gait analysis to generate a comprehensive treatment plan to optimize your child’s walking ability as they grow older. Surgery is focused on preserving muscle strength by correcting bony deformities and restoring soft tissue balance without cutting tendons in walking children. American Hospital offers single event multi-level surgery (SEMLS) for comprehensive deformity correction and gait optimization in walking children and teenagers affected by neuromuscular conditions such as cerebral palsy.
• Guided growth – Knee alignment in children usually changes up to the age of 8 years after which knock knees or bow legs can persist into adult life. Our pediatric doctors undertake comprehensive deformity analysis on standing x-rays to accurately quantify any deformity and advise you on whether treatment will improve your child’s comfort and function. Guided growth (temporary hemi-epiphysiodesis) is a modern technique for utilizing children’s innate growth potential to correct their knee alignment without the need for major surgery.
• Leg length equalization – Significant leg length differences due to congenital causes or previous injury may progressively affect children as they grow older. Our pediatric doctors are experts at undertaking comprehensive deformity analysis to determine the extent of shortening and/or limb angulation and generate predictions for the magnitude of any leg length or alignment asymmetry when your child is an adult. We offer a comprehensive range of treatment options including orthotics for mild leg length differences and surgery for major predicted leg length differences. Surgical options include leg length equalization with epiphysiodesis (slowing down the longer leg) and leg lengthening and deformity correction using a circular frame construct. Our dedicated multi-disciplinary team ensures that your child will have all the support they require through their leg-lengthening treatment program with dedicated input from physiotherapy, rehabilitation medicine, orthotics and clinical psychology. Our pediatric orthopedic doctors design treatment programs so that your child spends the minimum amount of time in a circular frame and can return to school and play free of this device as soon as possible.
The evaluation of your child’s pediatric orthopedic problem begins with a thorough history including antenatal history, findings at the time of birth and in early life, developmental milestones such as when your child started sitting up independently or walking, and any history of similar conditions in other family members. The symptoms and functional impact on the child’s schooling, physical activity, and well-being are explored in detail.
Your child will be made to feel comfortable throughout a physical examination by preserving their modesty and having a chaperone in attendance. A detailed physical examination is performed even if the problem may just be in the feet. Often the alignment of the leg as a whole may be contributory to the problem which is why a thorough assessment is required. Often, the history and examination are enough to furnish the doctor with sufficient information that can help define the most probable diagnosis or a list of possible diagnoses which need to be excluded.
The pediatric orthopedic service at American Hospital Dubai utilizes a comprehensive portfolio of diagnostic investigations to accurately characterize any deformity which may be causing symptoms in your child. Pediatric-specific diagnostic imaging protocols may include X-ray, Ultrasound, and MRI to measure the anatomical location and severity of the deformity. The X-ray images can also be manipulated through deformity analysis software that can help plan deformity correction surgery. X-rays are often not required at each visit, however, they may be undertaken to make a diagnosis, measure a deformity and assess improvement following surgery.
