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Orthopaedic out-patient care for children of pre-school age
1Department of Orthopaedic Surgery, Huddinge University Hospital, Sweden.
Insights
Orthopaedic referrals for children aged 0-6 years show hip conditions are common in infants, while foot deformities prevail in older children. Early diagnosis and treatment are crucial for pediatric orthopaedic conditions.
Area of Science:
- Pediatric Orthopaedics
- Child Health Surveillance
Background:
- A significant number of children aged 0-6 years require orthopaedic consultations.
- Referrals originate from various healthcare settings, including obstetric departments and children's health centers.
Purpose of the Study:
- To analyze referral patterns and diagnoses in a pediatric orthopaedic clinic population.
- To evaluate the frequency and management of common pediatric orthopaedic conditions.
Main Methods:
- Retrospective analysis of 466 children referred to an orthopaedic clinic (excluding trauma).
- Categorization of referrals by age, referring source, and primary diagnosis.
- Review of treatment outcomes for hip conditions and foot deformities.
Main Results:
- Hip conditions were the most frequent referral reason in infants (<6 months), while foot deformities (pes adductus, pes planus) were more common in older children.
- Congenital hip dysplasia diagnosis was confirmed in only 3 out of 90 children over one month old.
- Orthotic interventions were prescribed for 25% with pes adductus and 31% with pes planus.
Conclusions:
- Early detection of hip conditions in infants is vital, though over-diagnosis in older infants occurs.
- Foot deformities are prevalent in young children, often managed with orthotics.
- Streamlining referral criteria and diagnostic accuracy can optimize pediatric orthopaedic care.
Abstract:
Four hundred and sixty-six or 11.5% of a cohort of 4,039 children, aged 0-6 years, were referred to the orthopaedic clinic (trauma cases excluded). Twenty-three per cent of the children were referred from the obstetric departments, 64% from Children Health Centres, and 6% from district pediatricians. Up to the age of six months, referrals for hip conditions were most frequent, while above this age foot deformities were the most frequent reason for referral. The 466 children referred made 1,423 out-patient visits and were admitted on 52 occasions. Three hundred and sixty-nine radiological examinations were carried out. Of 83 infants referred for congenital dysplasia of the hip before one month of age, 54 were treated. Of 90 children older than one month, the diagnosis was confirmed in three. Of 80 children referred for pes adductus and 65 for pes planus, inserts or orthosis were prescribed in 25% and 31% respectively.