FAQ Category: Child


My 12 year old recently was bitten by our cat and now has a red track running up into his forearm.  Should I be concerned about this?  If I took him to the doctors, what could they do for him?

You should seek immediate medical attention for your son.  Cat bites typically carry a higher risk of infection rate and it sounds like your son has a well-developed infection that is quickly spreading.  The physician will begin him immediately on antibiotics and be able to determine how deep the infection […]


What is idiopathic congenital clubfoot?

Congenital means that the patient is born with it and idiopathic means it is of unknown cause. Clubfoot is known as Talipes Equinovarus – where the ankle and foot are in an atypical position (talipes) in that the foot points downward at the ankle (equinus) and the heel of the […]


What is developmental dysplasia of the hip?

In a normal hip the ball at the upper end of the thigh bone fits firmly into the socket. In babies with DDH the hip joint is not formed normally and the ball is loose in the socket so it’s easy to dislocate. The degree of hip instability will vary […]


My 9 year old son recently fell off our coffee table and dislocated his shoulder. I took him to the emergency room and it was put back in place and he was put into a sling.  What can I expect from here on out?  

The standard treatment for a shoulder dislocation from a trauma like falling on an outstretched arm is a period of immobilization (4-6wks) followed by physical therapy for gradual strengthening and return to function.  Surgery is only considered if the dislocation should happen again or if there was a tear of […]


My 14 year old son is keeps subluxing his shoulder.  He says this does not bother him and I’ve found him doing it for his friends’ amusement.  Should I be concerned about this?  Does he need surgery?   

Children and teenagers tend to be more elastic than adults. Over time, our tissues stiffen and the hypermobility, like your son has, becomes more of a hypomobility as wear and tear sets in.  It is in your son’s best interest that he stop subluxing his shoulder on demand and begin […]


I am a sports enthusiast — not just watching on TV but playing every sport that comes along. The problem is I’ve developed a hole in my right knee cartilage that is going to require surgery. The surgeon is going to plug the hole with a new collage treatment they are using in other countries. I’m going to ask at my next appointment about how soon I can be active again. But I thought I’d check on-line and see what I could find out. What do you people advise?

You might find the results of a recent study of interest. In this study, orthopedic surgeons from Italy explored the use of a minimally invasive, one-step osteochondral scaffold to repair damage to the surface of the knee joint. The level of evidence is low (rated four on a scale from […]


I just found out that my knee cartilage has separated from the bone underneath. So now I have something called osteochondritis dissecans or OCD. I’ve been told this problem won’t go away without surgery. Why not?

The condition known as osteochondritis dissecans or OCD is an acquired injury from repetitive microtrauma. A lack of blood supply to the damaged area causes separation of the first two layers of the knee joint: the cartilage that lines the joint (articular cartilage) and the subchondral bone (bone just under […]


Before agreeing to spinal fusion surgery for our eight-year-old son, I want full disclosure of all possible problems during and after the procedure. I have a list of things that can happen (provided by the surgeon’s office). Some of them are pretty scary like stroke and death. They said they would use the kind of screws (pedicle) that have lower risks and “superior” results. This does not make me feel any better. How often do these kinds of things really happen?

It might help you to know a little bit about the history of pedicle screws, how they are used, when they are used, and the results of some recent research related to the complication rates of these devices. Back in the 1960s, surgeons started to use this type of fixation […]


Our three-year-old granddaughter is going to have spinal fusion for a severe, severe scoliosis. She is developmentally disabled with a rare chromosomal abnormality. The surgeon showed us the screws they will use to hold the spine in place. She called them peddle screws and mentioned they are considered “off-label” but still safe. When I looked on-line about what off-label means, I got a little nervous about this for our girl. Are these things really safe?

According to a recent study done at The Musculoskeletal Research Center (Children’s Hospital in Colorado), pedicle screws for spinal stabilization are considered safe, reliable, and effective. Compared with other types of fixation (hooks, wires, rods), pedicle screws have a lower rate of complications. Superior correction of spinal deformity with fewer […]


I’m a little worried about the upcoming arthroscopic surgery our 11-year-old is going to have for a shoulder injury that causes his shoulder to pop in and out of joint. Any surgery would worry me but poking tubes into the shoulder of a growing child just gives me the willies. How safe is this procedure anyway?

Surgeons recognize that the use of shoulder arthroscopy in the pediatric population is a valuable tool that must be used carefully and judiciously. In all aspects of treatment (evaluation, preoperative and postoperative care, and the surgery itself), this age group is treated individually and not automatically regarded as adults in […]


What do they mean when they tell us “less aggressive” care is best for an arm fracture in children? Our son ended up in the emergency department over the weekend for a broken arm that was treated less aggressively (according to the physician’s assistant we talked with). They put the forearm in a cast on the basis of a single X-ray. Then we started hearing our friends tell horror stories of other children who got a cast but really needed surgery. Did we miss something important here for our child?

Current trends in treatment and evidence-based recommendations for management of upper extremity fractures in children support a “less aggressive” approach. Less aggressive is defined as fewer diagnostic tests, less medicine, no surgery (or slower time to surgery) with less invasive surgical procedures. Splinting or casts for short periods of time […]


We need some help as soon as possible. Our eight-year-old daughter has a broken arm (forearm to be exact). The on-call surgeon at the hospital recommended surgery but our pediatrician took a look at the X-rays and said a cast would be enough. If surgery is needed, it can be delayed without additional problems. We love and trust our pediatrician but the orthopedic specialist’s idea of surgery rings in our ears. Is the expert always right? Ack! I hate making decisions like this when it involves the kids!

There is a clinical trend toward more aggressive treatment for upper extremity (arm) fractures in children despite research evidence that less aggressive treatment is just as effective. Large studies that compared operative versus nonoperative treatments have concluded that less aggressive care is safe and effective. More aggressive treatment is not […]