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Paediatric Orthopaedics

Cerebral Palsy

This condition is caused due to an irreversible damage to the brain, which occurs before, during or after birth. This results in tightness of muscles in the limbs and occasionally in the trunk as well. These children are commonly referred to as ‘spastic’ children. The orthopaedic treatment involves physiotherapy, using certain medications like Botox injections to reduce the tightness and surgeries like correction of contractures, tendon transfer to balance muscles and bony surgeries to correct deformities and stabilize joints. These include pelvic osteotomies to stabilize hip and foot stabilization procedures.

Cerebral Palsy Before Treatment
Cerebral Palsy After Treatment

Club Foot

Also known as CTEV, this is the commonest congenital deformity requiring treatment. The current method of treatment is known as Ponseti’s technique of serial plastering. Neglected cases are treated with open surgery or correction using external frames.

Bilateral Club Feet
After Ponseti Treatment

Developmental Dysplasia of Hip

Previously known as congenital dislocation of hip, this condition has to be diagnosed early to be treated with a brace. If diagnosed late, surgery is invariably required. Many of these patients need to undergo complex pelvic osteotomies to reconstruct the socket. I specialize in reconstructive hip surgeries for patients who have had delayed diagnosis or failed surgeries for DDH.

Developmental Dysplasia of Right Hip
After Surgical Treatment

Limb Lengthening and Deformity Correction

Shortening or deformity of the limb due to congenital conditions, infections, trauma or any other cause can be corrected using special frames known as fixators which are available in a variety of designs.

Congenital Pseudarthrosis of Tibia
Congenital Pseudarthrosis
of Tibia – After Treatment

Muscular Dystrophy

Muscular dystrophy is a hereditary condition where there will be progressive weakness of upper and lower limbs due to a defect in the muscle. The problem may start at a very young age or during adolescence depending on the type of problem. The common types are Duchenne and Becker muscular dystrophies. These children require surgeries to correct limb or spine deformities or to stabilize the hip joints.

Obstetric Brachial Plexus Palsy

Obstetric Brachial Plexus Palsy is one among the severe types of birth injuries. The Incidence of OBPP in new born babies is 1.5/1000 birth. The child with shoulder dystocia has 100 times greater risk and large babies have 14 times greater risk, whereas twin or multiple pregnancy and caesarian section have protective effect. I have been treating children with this condition and routinely perform reconstructive procedures like contracture release, corrective osteotomies and modified quads procedure.

Obstetric Brachial
Plexus Palsy – Right Arm
After Corrective Osteotomy
OBPP Mods quad procedure pre op
OBPP Mods quad procedure post op

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