FAQ Category: Child


My wife is Japanese but married to me (an American) and we live in the U.S. She arranged for a sabbatical year in Japan at her job and we (myself and two children) went with her. While we were there, it was discovered that our 10-year-old daughter has a form of scoliosis they call “idiopathic”. The Japanese doctors there seemed really on top of the treatment of this condition. Now that we are back in the U.S., I can’t help but wonder if our doctor here knows as much as the Spine Group in Japan. How can I determine whether she is getting the same kind of care here as she got in Japan?

Idiopathic scoliosis is not an uncommon problem. Many primary care physicians and orthopedic surgeons see children of all ages with this condition. Idiopathic means the cause is unknown. In other words, the curvature does not occur because there is a neuromuscular disease, bone deformities of the vertebrae, or other condition […]


Is there any difference in the way scoliosis is treated based on age? Why I am wondering is because our five-year-old granddaughter has been diagnosed with this problem out of the blue. They say it’s pretty severe and she may even need surgery. But my neighbor has a granddaughter who is slightly older and they haven’t said anything about surgery yet. Is it better to do the surgery while they are younger and fix the problem. Or should we adopt more of a wait-and-see approach? After all, she could outgrow this, right?

Scoliosis is a deformity in the spine that causes an abnormal C-shaped (one curve) or S-shaped curvature (two curves). The spine is not straight but curves to one or both sides. There are three types of scoliosis depending on when it develops. Infantile occurs from birth to three years of […]


What do you think is the best way to treat a spinal cord injury in a youung child (five years old): body cast and then bracing or surgery straightaway? We’ve already made the choice but I’m curious to know what you would have recommended.

There was a recent review of studies done in this topic area. Two of the largest studies involving 122 and 179 children both showed significantly improved results in at least 80 per cent of the cases. Children with mild injuries and no neurologic damage are more likely to recover fully. […]


How is it possible that kids (even babies) can end up with a spinal cord injury? I thought this age group was pretty flexible, more like rubber and not quite rigid yet like adults.

Car accidents, falls from a height, and sports trauma are the three most common causes of such serious injuries in children. The lack of strength, increased laxity and mobility, and decreased spinal stability in children (as compared with adults) are additional reasons why pediatric and adult spinal injuries differ. In […]


My 10-year-old was perfectly fine until about two months when I noticed he was walking funny and he started complaining that his right knee hurt. He’s been diagnosed with Blount’s disease. The pediatrician thinks it’s because he gained a lot of weight and is about 80 pounds overweight. If he loses weight will this problem go away?

It’s a fact that more and more children, pre-teens, and teens are obese and facing problems they wouldn’t otherwise deal with. You may have heard that diabetes is one of those problems. But diabetes isn’t the only problem overweight children and adolescents face. As your child is now experiencing, Blount […]


What is the current recommendation for rotator cuff tears in children? Leave them alone and see if they can heal on their own? Or do surgery to repair the damaged structures?

Reports indicate that more and more children are developing sports-related shoulder injuries previously only seen in the adult population. Rotator cuff tears are among those problems. Though uncommon, these incidences are on the rise. Right now, partial-thickness tears of the rotator cuff in children and teens are treated conservatively (nonoperative […]


Yes or no? Is surgery needed for a clear break (and separation) of the collar-bone in a 13-year-old boy? He’s eager to get back to skate boarding and BMX racing. Surgery would really hold him back. What do you think?

There is a recent study from Rady Children’s Hospital in San Diego, California that may be the first to report detailed results of conservative (nonoperative) care of midshaft clavicular factures in adolescents. There were sixteen adolescents enrolled in the study in a 4:1 ratio of males to females (i.e., 12 […]


What can you tell us about Madelung deformity in children? We have a boy (age 12) who has just been diagnosed with this problem. Evidently, it is rare and even moreso in boys. We’ve just started our search on-line for information and hope you can help us.

Two orthopedic surgeons from the University of Washington (Seattle) Medical Center recently reviewed this wrist deformity and offered their opinions and preferred treatment. As you have discovered, it is, indeed, a rare wrist deformity affecting females four times more often than males. And as the name might suggest, it was […]


Our nine-year-old son was injured playing baseball, which turned out to be a good thing because when they X-rayed his arm for fractures, they found a tumor the size of a golf ball. They think it is a lipoma (fat tumor). We had no idea. He hasn’t had any pain and there’s nothing on the outside more than a slight bump to suggest a problem. We are waiting to see the orthopedic surgeon about this. What can you tell us while we wait?

Tumors of the arms and legs in children are actually fairly common. Fortunately, they are also usually benign. A careful and accurate diagnosis is still important as your orthopedic surgeon will probably tell you. The physician making the diagnosis in these cases must be very thorough as many cases can […]


My 15-year-old daughter may have a malignant tumor in the muscles of her leg. The clinic where I took her wants to do a whole body MRI. I’m concerned about several things. First, does she really need such a thing? And second, she’s just 15 and still developing. Will this cause harm or even keep her from having children later on?

Whole body MRI is used to help stage a cancerous tumor. It is a very common and important practice these days. Staging refers to determining how far along (or “advanced”) is the tumor. The results provided by this type of testing has greatly improved physicians’ accuracy in making a diagnosis. […]


Arm wrestling. This is the newest, latest craze among the teenagers in our area (including my two teen boys). I’m hearing a lot about elbow fractures on the inside of the elbow for the winners! Evidently, slam dunking the opponents arm down can put enough pressure on the funny bone of the winner to actually break it off. What else can you tell me about this kind of injury? How is it treated?

Arm wrestlers, gymnasts, football quarterbacks, and baseball pitchers along with cheerleaders, runners, swimmers, and hockey players were the subjects of a recent study you might find of interest. These athletes all had one thing in common: a medial epicondyle fractures (fracture along the inside of the elbow). Many factors go […]


Our little granddaughter (only nine years old) is quite a budding gymnast. But this week, she fell and broke her funny bone, which, as it turns out, is not so funny! They put her in a cast and didn’t have to operate so we’re thinking that’s a good sign. But I’m wondering if there’s a downside to all this. Will she, in fact, recover fully?

From the studies done on medial epicondyle elbow fractures (of the “funny” bone), the chances are very good for full recovery when the fracture is not displaced (separated) and the joint is stable. Those are the two main criteria for placement of the arm in a cast. Some surgeons warn […]


Just came back from the surgeon’s office where our 14-year-old daughter was examined for a patellar dislocation (three times now!) and MPFL rupture (MRI results).The surgeon made certain we knew what all the possible complications might be from the surgery (reconstruction of the ligament using her hamstring tendon). One of the biggies was “patellar fracture.” What would cause the knee cap to break during surgery and how likely is that?

Athletes of all ages are at risk for knee injuries, including young children and teens. One of the soft tissue injuries currently under study is the medial patellofemoral ligament (MPFL). This ligament is the main reason the patella (knee cap) stays in front of the knee joint and doesn’t shift […]


What went wrong? My grandson had surgery about six months ago for a chronically dislocating knee cap. They kept the same knee cap but took a piece of his hamstring tendon to replace the ligament that usually holds the knee cap in place. Everything seemed to go well and then the knee cap popped off again. We are wondering what went wrong? Can they get this problem fixed?

The use of graft tendon to replace the torn medial patellofemoral ligament (MPFL) is a fairly new procedure. Most of the results reported so far come from small studies. Reports of postoperative complications like this one are few and far between. But a recent study from Cincinnati Children’s Hospital may […]


When I was a teenager, I had scoliosis and took it upon myself to learn as much as I could about the condition. At that time, the surgeon always showed me the X-rays and explained the measurements and angles used to determine severity. Now my daughter is being evaluated for scoliosis. But instead of the Cobb angles we used to use, they showed us “centroid” angles. What happened to the old Cobb method?

For many years, X-rays have been used to diagnose and measure scoliosis (curvature of the spine). No matter how young or old the patient was or where the curve was located, this technique was used because it was simple and reliable. Then in the mid-2000s, researchers from the Scoliosis Research […]


Can you give me a quick run-down on best practice for osteomyelitis in a nine-year-old girl? I’m not a medical person but I am a CEO of a large company and want to help my family navigate her care so it goes smoothly with the best possible results.

Osteomyelitis (deep bone and/or muscle infection) is a condition that requires close communication and coordination of many hospital services (e.g., admission department, medical staff, laboratory and imaging studies, surgical staff, and discharge processing). A common sense approach is always welcomed. But evidence-based guidelines for evaluation, diagnosis, and treatment are needed […]


I am a frustrated parent of a six-year-old child who is currently in the hospital for a bone infection. It seems like there are too many cooks in the kitchen. The pediatrician, the orthopedic surgeon, and the nurses all seem to have different opinions about how to handle this case. How in the world does a parent navigate this kind of situation? I’m at my wit’s end.

You may have heard (or even used) the expression: easier said than done. That phrase is never truer than when changing the way complex health problems are addressed in a hospital setting. And that is especially true for osteomyelitis (deep infection of bone and/or muscle) in children. This is a […]


Do you think it is okay for a child with a broken ankle to have to wait a week or more before having surgery to fix it? I don’t understand why the doctors are dilly dallying when the X-ray clearly shows the bone is broken. Can you please explain this to me?

Ankle fractures can be challenging injuries in a child because there may still be an open physis (growth plate) that could be disrupted. The result can be deformity, a leg length difference, impingement, and overload of one side of the ankle. When planning the most appropriate treatment, pediatric orthopedic surgeons […]