Pediatric Orthopedics

American Hospital Dubai is fully committed to delivering world class treatment for pediatric orthopedic conditions, including traumatic, congenital and acquired conditions that affect bones and muscles. Our expert Pediatric Orthopedic Surgeons are part of a multi-disciplinary Paediatric Team including Physiothearpy, Orthotics and Rehabilitation Medicine delivering best in class care.

About Pediatric Orthopedics:

Pediatric Orthopedics is the science and practice of treating children with deformities of the bone, joints and muscles. It encompasses 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.

Children are different to adults when it comes to orthopaedic conditions. The treatments are also very different which is why it is best to see a Pediatric Orthopedic Surgeon. Children are constantly growing. Pediatric Orthopedic Surgeons are experts on growth and development and can inform you whether your child’s condition will improve as they grow and at what age and development stage treatment should be considered.

Pediatric Orthopedic Services at American Hospital

The American Hospital strives to deliver the best ethical treatment for each and every child based on the world class clinical expertise of the doctors practicing here. We pride ourselves on unparalleled expertise in children’s orthopedics so that you can feel confident that you have made the best choice for your child. Our services include:

• Emergency Pediatric Trauma surgery
• Walk in Fracture clinic
• Clubfoot Clinic
• Cerebral Palsy clinic
• Hip dysplasia Ultrasound clinic
• Limb deformity and leg lengthening clinic
• Pediatric physiotherapy
• Serial plaster cast treatment for foot deformity
• Serial plaster cast treatment for tip toe walking
• Brace/Harness treatment for hip dysplasia
• Single stage hip reconstruction for congenital hip dislocation
• Single stage hip reconstruction for cerebral palsy
• Single event multi-level surgery for gait optimization in cerebral palsy
• Minimally invasive deformity correction for knee deformity
• Leg lengthening and deformity correction
• Circular frame treatment


Pediatric Orthopedic Conditions We Treat:

Our portfolio of successfully treating pediatric orthopedic disorders covers all pediatric orthopedic conditions including:

• Pediatric Injuries/Fractures – American Hospital has world class expertise in the treatment of Pediatric Injuries using the most advanced techniques to offer the best outcomes. We treat both arm and leg injuries using plaster cast treatment, wire fixation, Elastic nailing, External fixation and Internal fixation using plates. Our aim is to use the least invasive treatment to restore your child back to full function.

• Pediatric hip disorders – American Hospital has focused expertise in diagnosing and treating developmental hip dysplasia with the most non-invasive treatments possible to achieve the best outcome. Our hip dysplasia ultrasound clinic aids early diagnosis when a hip brace may fully treat the condition. In cases where bracing may be ineffective, American Hospital offers the most comprehensive surgical treatment for congenital hip dislocation with the best chance of success. 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. American Hospital also has expertise in the treatment of Perthes disease and slipped upper femoral epiphysis using the most modern evidence based treatments.

• Pediatric foot disorders – American Hospital is the number one center for treatment of pediatric foot conditions such as clubfoot, flatfoot, high arched feet, tarsal coalition and congenital vertical talus. Ponseti treatment is undertaken by our dedicated clubfoot multidisciplinary team including pediatric orthopedics, physiotherapy and orthotics. Our Pediatric Orthopedic Doctors are experts in assessing and treating flatfeet and high arched feet with non-operative treatment as a first line. In cases which do not improve, our surgeons will discuss 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.

• Cerebral palsy (wheelchair users) – 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. Children with cerebral palsy who are wheelchair users are at risk of progressive hip dislocation causing difficulty washing and dressing, scoliosis, hip pain and stiffness. We provide postural management and physiotherapy with surgery reserved for progressive hip dislocation and knee contractures.

• Cerebral palsy (children with walking potential) – Children who are able to walk using mobility aids are at risk of losing walking ability as they progress into adult life. Our multi-disciplinary team ensures that walking is optimized and includes physiotherapy, rehabilitation medicine, orthotists and pediatric orthopedics. We undertake gait analysis to generate a comprehensive treatment plan for gait disorders. American Hospital offers single event multi-level surgery (SEMLS) for comprehensive deformity correction and gait optimization.

• Knee deformity (knock knees/bow legs) - Our pediatric doctors undertake comprehensive deformity analysis on x-rays to measure the deformity and advise you on treatment using minimally invasive techniques to correct the deformity as your child grows.

• Lower limb deformity – American Hospital offer comprehensive non-operative and surgical treatment options for 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. Our dedicated multi-disciplinary team ensures that your child will have maximum support during their leg lengthening treatment with dedicated input from physiotherapy, rehabilitation medicine, orthotists 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.


Book an appointment:

Ultimately, your child is unique and the most precious thing in the world to you. We work hard to ensure that as a parent, you can completely place your trust in us delivering the best possible care for your child. If you would like to consult with one of our doctors regarding your child’s treatment and care, you can book an appointment with us through the form provided on our website.

 

Not every bone, joint or muscle disorder in children requires early treatment. However, in some conditions “early detection”  may enable timely treatment with improved chances of a successful outcome and a lower risk of complications. In cases of congenital hip dislocation, early detection and treatment may lead to successful outcomes from non-operative treatment with a lower risk of complications. On the other hand flexible flat feet are very common in children and often cause no problems until the teenage years. In this condition, treatment should only be commenced when problems arise rather than needlessly treating all children who have flat feet with insoles which may have a bearing on their psychological well being.

During your consultation at American Hospital, the Pediatric Orthopedic doctor will take time to explain to you when it is it best to consider treatment for your child, and the scientific rationale behind this.

Depending upon the diagnosis of your child’s condition, the doctor will discuss what the outcome is likely to be if your child’s condition is left untreated. Some conditions may require treatment to help with symptoms but will improve over time even if they are untreated. For example, Sever’s disease (Heel pain in growing children) usually gets better over time even if left untreated. However, on the hand, some children will gain benefit from physiotherapy and gel heel pads while they have symptoms.

 

Although many pediatric orthopedic conditions naturally improve over time, some conditions like congenital hip dislocation in children give rise to progressive problems. When the child is young they may have no pain and only walk with a slight limp but if the condition is left untreated, it will lead to pain and stiffness requiring complex treatment in adult life.

Not every deformity in a child requires surgery. Surgical treatments are considered only after analyzing the impact of a deformity on the comfort and function of a child while taking into account the possibility of the condition worsening and causing more problems over time. For example, mild foot deformities that are not causing pain can be managed non-operatively and do not require surgery.

Surgery is usually recommended for severe or progressive deformities that cause problems despite the best non-operative treatment. Examples of such deformities include clubfoot deformity recurrence and moderate to severe congenital limb shortening.

Your child’s journey from clinic attendance to pre-assessment, the day of surgery, inpatient stay and to rehabilitation will be discussed in detail during your consultation with a Pediatric Orthopedic Specialist. We will explain what improvements can be expected following treatment by sharing treated case examples to better understand the timeframe for clinical and functional improvement.

Surgical treatment will be offered if there is a realistic expectation that the condition cannot be treated non-operatively, or that the condition has not satisfactorily improved with non-operative treatment.

Musculoskeletal discomfort can frequently arise during childhood, especially during periods of rapid growth and when children’s physical activity levels are high. Growing pains frequently arise in teenagers as they progress through the adolescent growth spurt where growth velocity peaks and the muscles in the soft tissue envelope can become tight. Symptoms usually improve as growth slows down and can be aided by physiotherapy to stretch the tight muscles. In young children, benign type leg pains can arise due to the excessive physical demands children place on their legs due to high activity levels at this age. Although most lower limb discomfort in children may be benign in origin, it is important that you are reviewed by a specialized Pediatric Orthopedic doctor who can ensure that there is no alignment problem or other pathology giving rise to these symptoms.

Some conditions like bow legs in infants usually improve by 2 years of age and do not require treatment. Similarly, flat feet may also cause no problems until teenage years when the child gets heavier and the joints get stiffer. During the patient’s consultation with the Pediatric Orthopedic doctor, the patient and family will be presented with evidence based illustrations and graphs to understand how their child’s condition will improve over time, and when they might require medical intervention.

There are many factors to take into account when deciding the best treatment plan for a specific child - the diagnosis and severity of the condition, the natural history if left untreated, the impact on the child’s comfort and function and the patient and family’s treatment choice must all be taken into account. The doctor will recommend a specific treatment plan taking all of these factors into consideration having carried out a thorough patient evaluation and reviewing the findings from investigations. Treatment programs in pediatric orthopedics include physiotherapy, orthotics, surgery or a combination of these treatments. The doctor will discuss if there are alternative treatment options to surgery and the outcomes from operative and non-operative treatment.

Often children and their families get confused by different medical opinions from different professionals. This is especially the case when a recommendation of surgical treatment has been made. At American Hospital Dubai, we approach each child with a clean mindset to assess and diagnose the problem. We hope to deliver a comprehensive consultation in terms of assessment and treatment planning so that the child and their family feel fully informed to make the best treatment choice for their child.

 

The American Hospital strives to deliver the best ethical treatment for each and every child based on the world class clinical expertise of the doctors practicing here. Following the consultation, you will receive a detailed report outlining the clinical presentation, examination findings, plan of investigation, and discussion on treatment options and likelihood of expected outcomes. The American Hospital supports patients in seeking additional opinions from doctors working in other institutions before choosing the American Hospital for their child’s treatment. American Hospital prides itself on unparalleled expertise in children’s orthopedics so that you can feel confident that you have made the best choice for your child.

Ultimately, your child is unique and the most precious thing in the world to you. We work hard to ensure that as a parent, you can completely place your trust in us delivering the best possible care for your child.

Often, the child’s history, examination, and basic X-rays provide sufficient information to make a diagnosis and devise a treatment plan. In some cases, an exact diagnosis requires further investigations. The Pediatric Orthopedic doctor will guide you on the course of investigation to help make a diagnosis which may include Ultrasound, MRI, or CT.

Doctors Panel of Pediatric Orthopedics

Assad Qureshi

Consultant Pediatric Orthopedic Surgeon

English, Urdu

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