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Emotional Educators

How to help children with an external fixator

Coping with a child with an external fixator can seem like a daunting task for both the parents and yourselves as educators. The important thing is to make children feel happy and comfortable.

A child with an external fixator is usually off school for the first two weeks of the treatment. After this period of time most children can attend school with the frame on.

If a child in your care requires a wheelchair post op, the school will need to have ramps for easy access. The child won’t be able to move as freely as they could before their orthopedic surgery.

If the child is only using crutches, he/she should be able to move around school quite well. There isn’t any danger to the child or others if the frame is knocked, however assisting the child from class to class may be helpful in preventing such instances.

Initially, leniency on the proposed school uniform could be beneficial. Due to the width of the rings on a fixation device, shorts and baggy trousers or tracksuit bottoms are recommended in order to give the fixation device as much room as possible to avoid rubbing, which could cause irritation or move the frame from position. Although special footwear can be created to fit around metal wear when external fixators are applied around the foot and ankles, most children will be able to wear normal footwear once the orthopedic surgeon allows it. Until then we would recommend leniency with this also.

Openly discussing treatment, emotions and worries, recovery and future goals with a child that has just had orthopedic surgery is highly encouraged. If you think that a child is not coping very well with his/her treatment plan, it is important to let a parent know so a specialist can be made aware and the child’s specific issues can be addressed and corrected.

 

Categories
Emotional Parents

Back to school with an external fixator

Your child must gradually learn to move around with ease doing things he/she used to enjoy. He/she must also learn to be unashamed of his/her orthopedic external fixator. It’s very important for the limb’s healing that your child starts mobilizing soon: he/she must go back to school as soon as safely possible. There he/she can meet school friends, start studying again and get back to a normal routine.

A recovery timeline can be discussed with surgeons and from there you can let school staff know what is happening. They will then be able to prepare for your child coming back to school as well as providing any work that your child has missed while having surgery.

It is important that you and your child talk about his/her external fixator with teachers and friends. This will make school staff and school mates more aware of your child’s special needs regarding extra space, mobility limitations, and rest elevating the affected limb.

Categories
Treatments Parents Safety

Travelling with an orthopedic fixation device

Before deciding to go on a trip with your child, it is important you speak to their health care professional. They may not want your child to travel too far away because of the risk of infection, clots or anything that could happen to the fixation device.

If your child’s doctor says it is okay for your child to travel, ask for a letter from your orthopedic surgeon to pass through security at the airport with the fixator in place and/or medicines related to the surgery.

If flying with an orthopedic fixation device, your child should:

– avoid any salty food and avoid alcohol;

– drink water often;

– use a pillow to help support their limb;

– ask the hostess/steward on board for ice in case the limb starts swelling during the flight;

– show the fixator off – it will make people more aware of his/her needs regarding extra space;

– make sure to have adequate medical supplies such as dressings, pain relief, etc.

– when at the airport, get help with wheelchairs, going and coming from the planes. Be patient and allow yourself plenty of time, as the wheelchair person may be late or the gate may be far away;

– if needed, the carrier could decide to have medical staff on board.

If travelling by car, your child should:

– sit in the front with the seat pushed back, or in the back seat with the legs across the seat;

– use a pillow to make the journey more comfortable.

If travelling by bus or by train, your child should:

– choose the aisle seat – it will be most comfortable as he/she should be able to stretch the limb out.

In all cases, elevate the limb during the journey as much as possible and take regular stops to walk around.

Categories
Parents Safety

Child safety seat for car security

Motor accidents are the most common cause of death for children ages 4 and 14.

Child safety seats have been shown to decrease car death by 71% for kids under 1 and
by 54% for kids aged 1 to 4 years old.

Please follow the tips listed below:

  • It is mandatory to use child safety seats every time we drive, even if it’s a very short journey.
  • Putting children on your lap is never a good idea – this can cause accidents and make driving very unsafe.
  • The back seat is always the safest place for any child safety seat.
  • All car seats must come with the appropriate safety standard labels. Never use one without your country’s accreditation.
  • For a Safe Car Seat Installation, follow instructions from the manufacturer. Do not try to guess!
Categories
Physical Parents Health and Prevention

How to build strong bones in children

It’s easy to take our bones for granted, but they can break, and they take time to heal – even when we are young. We build almost all our bone density and strength when we’re children and teens. Adults build new bone but more slowly, and over time bones get weaker.

As a parent you can make sure your kids get the three key ingredients for healthy bones: calcium, vitamin D and exercise.

Calcium can be found in dairy products, beans, cereals, some nuts and seed,s and leafy green vegetables. Encourage your kids to eat high-calcium foods. Younger kids may need 2–3 servings of calcium-based products each day, while older kids may need 4 servings.

Vitamin D helps the body absorb calcium and can be found in foods such as tuna, cheese, egg yolks, mackerel or salmon, and fortified fruit juices.

Health care providers recommend all kids take a vitamin D supplement if they don’t get enough in their diet. Ask your doctor, nurse practitioner or a dietitian how much vitamin D your child needs and the best way to get it.

Your child’s muscles get stronger the more he/she uses them. The same happens with bones.

Walking, running, jumping and climbing are good for building strong bones, as muscles and gravity put pressure on them. Riding a bike or swimming are great for overall body health, but kids also need to do some kind of weight-bearing exercise for about an hour per day.

Categories
Emotional Treatments Parents

Spotting stress in children

It’s important to remember that kids still experience stress. Things like school pressure, friends and everyday social situations can contribute.

Here are a few ideas of how you can encourage your child to express himself/herself:

– Talk about what you may think is bothering your child, be sympathetic and show you care.

– Listen, be patient and ask your child questions.

– Suggest what you think he/she may be feeling and help him/her process what’s happening.

– Put a label on it to help your child understand his/her own feelings and make him/her realize he/she isn’t alone.

– Suggest ways to tackle the issue together, this will make him/her see that problems can be solved when discussed.

– Limit stressful situations when possible.

– Simply be there, to listen and talk.

– Be patient. You can’t solve every problem, but listening and understanding goes a long way.

 

What do kids worry about?

Kids and teens can worry about grades, tests, their changing bodies or simply fitting in.
They may feel stressed over social troubles like peer pressure, family problems or whether they’ll be bullied, teased, or left out.

Preteens may worry about world events or issues they hear on the news or at school. Things like terrorism, war, pollution, global warming, endangered animals, and natural disasters can become a source of worry.

 

How to reduce stress in children?

Here are a few suggestions to help your child:

– Take an interest in what’s happening in and out of school and try to discover if there is a particular issue that’s causing distress.

– Encourage your child to talk about what’s bothering him/her. Sometimes all kids need is a little reassurance.

– Show you care and understand by listening.

– Help them solve the problem or issue themselves and don’t automatically fix it for them. If it is based around world events, take them to a library or encourage them to research to understand more.

– Help your child keep things in perspective.

– Help them see that you’re committed to changing the things they are feeling stressed about.

– Be aware of your own emotional reactions to problems and issues – these can be transferred to kids.

– Be a good role model – your child will mirror your actions.

Categories
Emotional Treatments Parents

How to prepare your kids for the hospital?

Good preparation can help your kids feel less anxious about surgery and get through the recovery period faster. But, like parents everywhere, you’re most likely a little uncertain about the best way to prepare your child.

Explain things in a way that your child understands. Kids of all ages cope much better if they have a good idea of what’s going to happen and why the surgery is needed. Ask your healthcare professionals any questions you have, and do your researches so that you know how to answer questions that your child will ask.

The more you understand, the more your child will too

Ask your doctor for appropriate videos or tools that can help explain the procedure.
Find books, appropriate to your child’s level of understanding, about what to expect at the hospital. Reading together and discussing the surgery will make everything seem less threatening.
Remember that as well as the words you use, your tone of voice, expression, gestures, and body language send messages to your child. If you appear fearful, your child is likely to feel fearful regardless of the words you use.

Consider a pre-operative orientation and tour

Hospitals can offer special pre-operative children’s programs, family orientations, and hospital tours. Child-life specialists are an incredible resource for parents and children. They are trained to talk to children about their medical procedures, comfort them if they’re upset or need extra support, and they can even organize group times to get together with children that are going through the same things. An orientation program removes the mystery of the surgery and makes the hospital familiar and friendly and the experience more predictable.

Hospital stays

Many surgeries are now “same-day” procedures with no overnight or prolonged stays needed; many kids are back home the same night.

Anesthesia is much safer today than in the past, but it can still carry some risks. Discuss any concerns you have in advance with the anesthesiologist.

If hospitalization is needed overnight, most hospitals avoid separation anxiety by permitting at least one parent to stay with the child day and night. Check with your hospital about its rules regarding parents staying over and when other close family members can visit.

Explaining the problem and handling fears

Begin by explaining why surgery is needed in simple terms; kids may fear that you aren’t telling them everything, or that their problem is worse than they’ve been led to believe. Build trust and don’t mislead your child – tell as much of the truth as your child can understand.

Kids will most likely be scared that the surgery will hurt. Explain them that a special doctor gives medicine to make them sleep so they won’t feel anything during the operation. Once it is finished, they’ll wake up. Older kids, in particular, may need special assurances that they will wake up.

Explain that you’ll be there when your child wakes up. Tell your child that if anything feels sore right after the operation, a doctor or nurse can give them medicine that will make it feel better.

A teen might be afraid of losing control, missing out on events, being embarrassed or humiliated in public, and sounding childish by expressing fear, anxiety, or pain. A teen also may be afraid of waking up during the operation – or not waking up afterward.

Encourage your teen to read up on their medical condition and share the information with you. Reading and sharing information is an excellent coping mechanism.

A fear of all ages is being seen naked and having their “private parts” touched. If the operation involves the genital or anal area, explain that although it might be embarrassing, doctors and nurses will need to examine these areas, to check if they’re healing after the operation. Be sure to explain that doctors, nurses, and parents are the only exceptions to the rules about privacy.

Children sometimes believe that their medical problem and operation are punishments for “being bad.” They may feel guilty and believe that they’ve brought events on themselves.

Explain that the medical problem is not the result of anything they have done or failed to do, and that the operation is not a punishment, but simply the way to “fix” the problem and that they will feel so much better afterwards.

On the day of orthopedic surgery

When you arrive on the day of surgery, your child will have time to wait, so its recommended you bring books or toys from home to pass the time.

After surgery you’ll be allowed in the recovery room to be with your child as he or she awakens.
Distracting your child, whether with a new book or a visit from a relative or friend, can also make recovery more pleasant. Just make sure your child gets plenty of time to rest and recover.

Categories
Physical Treatments Parents

Guide to use of crutches

Getting around on crutches can be tricky at first, but with a few helpful pointers it can be easy and less of a hindrance as you may think.

How to choose the size of crutches?

Ensure the crutches are properly sized so they do not cause problems. Don’t assume the crutches you have at home are the right ones, they may need adjusting.

Proper crutches should be one to two inches below your armpit when you are standing straight. The handles should be at hip height, so that your elbows are slightly bent when holding them.

Check padding and grips of the crutches

Crutches should have ample cushioning on the armpit and grips where the crutches contact the floor.

How to get up from a chair with crutches?

Place both your crutches in the hand on the affected side and grasp the hand rest of a chair with your other hand. Place your weight on your uninjured leg and push up with your arms.

Walking with crutches

Both crutches should move together a short distance in front of you (approximately 18 inches).
Always ensure you take short steps when using crutches. Support yourself with your hands and allow your body to swing forward as if you were going to step on the injured leg; instead of placing weight on the injured leg, rest your weight on the crutch handles.

When going up and down the stairs, go one step at a time, and rest at each step – it’s not a race!

Going up the stairs 1

Stand close to the step, place the crutches at ground level. With your weight on the crutches, pick the uninjured foot up to the step, and then bring the crutches up to the step level. Repeat this process for each step.

Going up the stairs 2

If the stairs have a handrail try holding onto it – with both crutches in the other hand – only if you feel confident to do so.

Going down the stairs with crutches – if you can’t bear weight on your injured leg

If you cannot bear to have any weight on the injured leg, you will need to hold the foot of the injured leg up in front and hop down each step on your good leg. Be sure to support yourself with the crutches or get someone to help you.

Going down the stairs if you can bear some weight on the injured leg

If you can bear weight on the injured leg, place the crutches on the next lower step and step down with the injured leg. Then quickly bring down the good leg. But remember to take it one step at a time.

Don’t let your armpits rest on the crutches, even when resting!

Categories
Emotional Physical Parents Health and Prevention

Motivating teenagers to exercise

The important thing in motivating teens is discovering something that is really fun for them. Not everyone is born to be an athlete, so it’s important to find out if there are some activities that aren’t seen as exercise or competitive and are simply ways of enjoying everyday life.

Never push your child into a sport simply because it’s what you did. Instead, try to talk through what things are interesting to them. It might be that solo pursuits like running or cycling are a better fit than team sports like football.

Competitive sports can add extra stress and pressure, and not everyone thrives in that environment. However, if your child shows a particular skill or aptitude and does like a competitive environment, encourage them. Team sports are great for exercise and building personal skills.

Think outside the box

Try to look beyond the typical forms of exercise or sport. Yoga can be a great way to ensure flexibility and well-being. Going to the gym or swimming might be more interesting to your child. Rock climbing or hiking are great ways to see the great outdoors. Anything requiring movement promotes a healthy lifestyle.

The main point to remember is to listen to what your teenager is interested in and support him/her in whatever exercise he/she feels comfortable with.

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Emotional Physical Parents Health and Prevention

How to make your child active?

From an early age it is important that your children are encouraged to play, exercise and explore. This builds confidence, social skills and physical development.

Regular exercise can prove to be vital in later life, promoting:

    • strong muscles and bones;
    • healthy weight;
    • decreased risk of developing type 2 diabetes;
    • better sleep;
    • a better outlook on life.

It’s proven that active kids are also more likely to be motivated, focused, and successful in school.

Motivate kids to play

The main advice is to keep it fun and light hearted – no child wants to participate in physical exercise if it isn’t fun. Support your child and try to choose things he/she would enjoy rather than just endure. Make it a fun game.

Choosing age-appropriate activities

Try incorporating physical activity into a daily routine. Toddlers and preschoolers should play actively several times a day. Children aged 6 to 17 years should be doing 60 minutes of physical activity daily.

Age-based advice

Younger children need games and exercises that helps them develop motor skills – kicking or throwing a ball, riding a bike with training wheels, or running obstacle courses can all be good.

Some sports may be open to kids as young as 4, although organized team sports are not recommended until children are slightly older. Sometimes kids can’t understand rules and can lack the attention span, skills, and coordination needed to play, but they should still be encouraged to do some form of activity. Remember not to take it too seriously; the fact that they are running around being active is what matters.

School age children can often spend too much time in front of a TV or on electronic devices, so the challenge for parents is to find something they would rather do.

Talking and understanding what they may be interested in is key to identifying the right kind of sport to suggest.

Teenagers have a huge range of choices when it comes to being active: football, running, cycling, baseball, skateboarding, hockey – all of which are great ways of staying active and are normally available to participate in at school or on weekends.

Understanding your child’s attitude to sport

  • Non athlete

General lack of athletic ability, interest in physical activity.

  • Casual athlete

Generally interested in being active but is at risk of getting discouraged in a competitive athletic environment.

  • Athlete

High athletic ability, committed to a sport or activity and likely to excel with the right support.

Regardless of which category your child falls into, be positive and support any form of exercise that your child shows an interest in – it all helps promote a healthy lifestyle.

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Emotional Physical Parents Health and Prevention

How to keep your kid active?

Kids love to play and it’s an essential part of their growth, so it should be encouraged. Not only should their body be active, but their brains also need stimulation.

Don’t let young children spend extended periods of time in high chairs, strollers, and car seats. Screen time on televisions or electronic devices should also be limited.

Playing with toys is a much better way of keeping minds and bodies active.

 

Here are some ideas to keep toddlers active at home:
12-24 months

-Listen to music and encourage dancing together

-Jumping – while holding your toddler’s hand

-Climbing stairs with supervision

-Playing with building blocks and other physical toys

24-36 months

-Play at the playground

-Gentle ball games

-Toy cars

-Building blocks

 

Investigate how active your kids are away from home supervision, for example:

– Do they go outside most days?

– Is there a schedule of activities they adhere to?

– Do they watch videos or TV, and if so, how much and how often?

Think about joining a playgroup. Playgroups offer a change of pace.

 

Safe environments and playgrounds

Play areas must be safe, so always check that a playground has age appropriate equipment that is clean and well-maintained. Some children do not have any fear and will attempt things that could be dangerous. To reduce the risk of injury and make playing more fun for everyone, stick to play areas that are designed for your child’s age.

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Emotional Physical Parents Health and Prevention

How to encourage children that don’t like sports to exercise?

Team sports can be great to keep kids fit and help them with self-esteem, learning about teamwork and making friends, but sometimes children can be a little reluctant to participate.

Some kids find it difficult to take part in team sports for a variety of reasons. Shyness, fear of not being good enough, or worrying about looking foolish in front of friends are feelings that can all impact your child’s interest in sports.

Kids are still developing basic skills

It isn’t until around the ages of 6 or 7 that kids start to develop the physical skills needed to effectively play sports. One thing you can do to help them is practice: the more your child plays sports with you and friends at home, the more confident he/she will be in a competitive setting. It also means you will spend quality time together!

Your child may enjoy playing sports for the fun of it, but doesn’t want to compete. Listen to your child. He/she may be more likely to enjoy the sport if it’s just played for fun.

Make the right choices when it comes to skill level

Try to assess your child’s skill level when selecting teams or sports. It’s not a good idea to push your child into a sport if he/she isn’t ready. Many sports have beginner level classes, and can be the best place to start when your child is still learning the basics.

Fight or flight

Some kids aren’t natural athletes. It’s important to provide positive encouragement and support from the start so they understand that it’s okay to make mistakes. Learning a sport takes time, and everyone makes mistakes.

Choosing the right activity

Have an open mind when selecting the right sport for your child. Some kids struggle with coordination, so sports like cycling or swimming might be a better option than football or baseball.

Other factors

Many factors impact a child’s ability to participate in sports. They may be overweight, have asthma, or some other health issues that make it difficult for them to keep up. Try to select a sport that is appropriate for your child’s attitude, skill level, and interests. If your child doesn’t enjoy a sport, they won’t want to do it.

When team sports aren’t right

If a team sport isn’t a good fit for your child, here are some individual activities to try:

  • swimming
  • horseback riding
  • dance classes
  • inline skating
  • cycling
  • cheerleading
  • skateboarding
  • hiking
  • golf
  • tennis
  • fencing
  • gymnastics
  • martial arts
  • yoga and other fitness classes
  • running

Be patient

Sometimes finding the right sporting activity can take time and patience. It’s important to find an activity that feels like a hobby and not a chore. The reward of finding the right activity for your child and promoting a healthy lifestyle will be well worth it.

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Treatments Parents Health and Prevention

Bone deformity correction: when is it time for Health Care Provider consulting or check-ups?

Human skeletal development starts during pregnancy and continues until bones have reached their full shape and structure in late puberty.

Some bone deformities are evident at birth, such as clubfoot, while others generally occur between 10 and 18 years old, such as scoliosis where the spine has a side-to-side curve, with an S or a C shape.

If your child shows signs of a bone deformity, you should take them to your Health Care Provider as soon as possible for an assessment. The earlier a bone deformity is diagnosed and treated, the more successful the treatment will be.

Your HCP and/or orthopedic surgeon will carefully evaluate what is appropriate for your child, considering the following aspects: your child’s age; her/his medical and family history; a physical examination; imaging, and blood and/or nerve tests.

It is important that you feel comfortable asking your HCP any questions about your child’s diagnosis and treatment that you may have. The better informed you are, the more comfortable you and your child will be.

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Physical Treatments Parents Conditions Bone Fractures

What is a growth plate and a physeal fracture?

Almost every bone in your body has a physis. The physis (or growth plate) is made of cartilage and is near the ends of the long bones. Physis helps bone grow in both length and width. When a child stops growing, the physis hardens into solid bone.

Physeal fractures are very common; the most common types of fractures are found in the fingers, wrists and lower leg, mostly from overuse and in playing sports. The physis can fracture and although physis can heal very quickly, it’s important to bring your child to an orthopedic specialist as soon as possible after an injury occurring.

Physeal fractures classification

The Salter-Harris classification describes the different patterns of physeal fracture:

Type I fractures
This could just be a crack in the physis that is still perfectly aligned, or the physis may be disrupted and the bone separated.

Type II fractures
A fracture that is partly through the physis and then out the shaft of the bone away from the joint.

Type III fractures
A partial fracture through the physis and then exits the end of the bone into the joint. The joint surface may be disrupted.

Type IV fractures
A fracture that goes through the shaft of the bone, also through the physis, then exits out the end of the bone at the joint.

Type V fractures
Part of the physis is crushed but not displaced; these can be very difficult to see on X-rays.

Physeal fracture symptoms

Swelling, pain, bruising, and a crooked limb with the inability to move are the most obvious signs that a physeal fracture has occurred.

Physeal fracture examination

A doctor will need to test the joints and force some gentle movement to diagnose the problem. They will then conduct X-rays, MRI or CT, which can help to correctly identify a physeal fracture.

Physeal fracture treatment options

Treatment will depend on the specific injury. Treatment options include a cast or surgery using metal pins or screws.

Physeal stress fractures can often heal with rest, although a splint or cast may be used to help with the pain. Following healing, it’s important to reduce stress on the affected area and avoid any activity that could cause further injury or stop the healing process. Your surgeon will give you guidelines on this.

Physeal fracture surgical treatment

Surgery may be needed if:

  • the skin is cut near the broken bone;
  • the fracture will not stay lined up even with a cast;
  • bones have started to heal incorrectly.

Implants can be used in surgery to keep the bones aligned properly. This can include plates, pins or screws to help keep the bones aligned while healing.

Outcome

Growth plate fractures, especially in the femur (upper part of the knee), must be monitored for 9 to 12 months after injury to ensure the bone grows properly. X-rays are needed to monitor progress.

If a hard-bony area forms across the physis, it may stop growing properly or grow in a crooked form. This is very rare, but if it does happen, there are different techniques for removing the bony bridge, including inserting some fat into the area, or cutting the bone to adjust its growth pattern. Your doctor may suggest surgery to prevent this from happening.

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Treatments Conditions Parents

What is Pes Planus?

Pes Panus deformity is more commonly known as flatfoot. Both children and adults may be flat-footed, and it’s estimated that the prevalence of Pes Planus in the general population is about 20-30%.

What causes Pes Planus?

The foot must act as a reliable landing point when putting the foot down, usually heel first, and as a rigid taking off point when walking or running. In pathological flatfoot, the arch of one foot or both feet have either not developed normally, or an injury or condition has produced it, such as rheumatoid arthritis, stroke or diabetes. It may develop as a result of degenerative changes in joints and/or ligaments; this will tend to be in older patients and people who are very heavy. It may also occur as a result of trauma to the bones and/or ligaments. An increasingly common cause seems to be neuropathic problems secondary to diabetes, as an early manifestation of Charcot foot.

Pes Planus symptoms

The arch of the foot is lowered or flattened out, depending on the severity. Slightly lowered arches are usually symptom free. Issues such as discomfort and chronic pain can arise if there is a minor injury, sudden weight gain, poorly-fitted footwear, and excessive standing, walking, jumping or running.

Pes Planus diagnosis

Pes Planus diagnosis is usually by clinical examination. In young people, the flat foot that is apparent when standing disappears when they stand on tip toe, and the normal arch appears. This is flexible Pes Planus, is usually symptomless and requires no treatment. X-rays may be helpful when there is a history of injury but may not be necessary.

Pes Planus treatment

Management in less severe cases of Pes Planus generally consists of wearing spacious, comfortable footwear with good arch support, possibly supplemented by padding or orthotics in order to balance and cushion the foot. The object of Pes Planus treatment is to restore anatomy and function as much as possible. Orthopedic surgery, sometimes with osteotomy, may be necessary. Bone grafting to replace lost bone may be also necessary. After surgery, your child may need to wear orthotics. Since each case is different and there are many types of treatments, discuss the best treatment for your child with your doctor and orthopedic surgeon.

Pes Planus deformity complications

If not treated, some cases of Pes Planus can result in severe deformity and early onset of arthritis of the foot and ankle. This may cause severe pain and significantly reduce the ability to walk, even when wearing orthotics.

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Treatments Conditions Parents

What is Pes Cavus?

Pes Cavus is another name for a high-arched foot. Prevalence in the population is estimated to be 8-15%.

What causes Pes Cavus deformity?

Severe Pes Cavus can be caused by progressive neurological disorders (e.g., spinal trauma, muscular dystrophy, hereditary neuropathy), static neurological disorders (e.g., stroke, cerebral palsy) and other causes, such as foot trauma.

Pes Cavus disease symptoms

The shape of the foot may range from a slight high arch to a severe deformity that causes a patient to walk on the outside of the foot.

Pes Cavus diagnosis

An X-ray will confirm a diagnosis of Pes Cavus and its severity.

How to treat Pes Cavus?

Slight high arches are usually corrected or managed with specially designed footwear (orthotics) and severe deformity may require orthopedic surgery to achieve realignment. Osteotomy (the surgical cutting of a bone or removal of a piece of bone) and an external fixation device can correct a severe bone deformity, thus reducing pain, improving function, and decreasing the incidence of deformity-related injuries, such as ankle sprains and broken bones. However, realignment through an external fixator must be supplemented with soft-tissue-balancing procedures, such as tendon transfer and orthotic management, in order to maintain the correction.

Pes Cavus complications

Left untreated, Pes Cavus causes foot pain, and potentially knee, hip and back pain that limits mobility. People with Pes Cavus deformity may also be more prone to broken bones in the lower legs.

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Treatments Conditions Parents

What is Charcot-Marie-Tooth disease?

Charcot-Marie-Tooth disease (CMT) is a group of inherited neurological disorders involving the peripheral nerves. Peripheral nerves are outside the brain and spinal cord, and govern the motor and sensory capabilities in the limbs (such as walking). CMT’s estimated prevalence in the general population is 1 out of 2,500 (0.04%).

CMT is caused by congenital mutations in genes involved with the structure and function of the nerves governing feet, legs, hands and arms. There is no single faulty gene and there are many varieties of CMT caused by different genetic faults.

Charcot-Marie-Tooth disease symptoms

CNT usually develops between 5 and 15 years old, but it may develop later. Foot deformities may occur, and the lower legs may have an “inverted champagne bottle” appearance as muscle bulk is lost. As the disease gradually progresses, weakness and loss of fine motor skills may occur, with pain ranging from mild to severe.

Charcot-Marie-Tooth disease diagnosis

A neurologist can diagnose CMT after nerve conduction studies, electromyography to measure the electrical activity of muscles, and sometimes by nerve biopsy.

Charcot-Marie-Tooth disease treatment options

Although Charcot-Marie-Tooth disease cannot be cured, it can be managed with physical therapy, braces, pain medication and surgery. Osteotomy and treatment with an external fixation device can help to reverse foot and joint deformities, aiding support and strength.

Charcot-Marie-Tooth disease complications

Left untreated, CMT leads to pain and difficulty walking, which decrease everyday activity levels and adversely affect quality of life. Foot wounds, foot fractures and more-severe deformities of the foot and ankle may also occur.

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Treatments Conditions Parents

What is angular deformity of long bones in growing children?

Angular malalignments of long bones are a common concern in the early years of life. In most cases, symmetrical deformities and absence of symptoms present a benign condition with excellent long-term outcome.

On the contrary, deformities that are asymmetrical and associated with symptoms may indicate a serious underlying cause leading to aesthetic and functional deficits that will require surgical orthopedic treatment.

At what age can angular deformity of bones be considered a pathology?

Genu varum (bowlegs) are normal in newborn and infants up to 12 months. It improves with growth: when child starts standing and walking the lower limbs gradually straighten (with normal growth) and the genu valgum spontaneously correct at the age of 7. If they persist after the age of 10, they may require surgical orthopedic treatment.

Angular deformity causes

Some experts think that a high amount of stress and strain imposed too early on a joint, during growth and/or adolescence (for example, through intensive sport practice) may contribute to this type of growth deformity, but so far not enough scientific data is available. However, it’s known that the most frequent causes of angular deformity of long bones in children are growth disorder, previous trauma or injuries, cancer and/or infections, or a pathologic condition – often caused by Blount’s Disease (tibia vara) and renal rickets, or vitamin D deficiency.

Angular deformity diagnosis

Familiarity with the natural history of angular deformities and with normal growth patterns is necessary to diagnose and evaluate malalignment. Diagnosis should include family history, any description of onset and information about the progression of the bone deformity, plus a selective use of X-rays, CT and MR imaging. The child will be observed walking, with attention to her/his knees during the stance phase, to determine if lateral thrust (genu varum) or medial thrust (genu valgum) occurs. The doctor should know the diet and amount of vitamins taken by the child, inquire about milk allergy, or intoxication of metal – specifically to lead and fluoride.

Angular deformity treatment options

Treatment options depend mainly on the degree of bone deformity and the age of the child. Treatment is rarely required if the child is under 18 months. In case of moderate, milder deformity (stage I and II), this can be treated with a night time orthosis, and/or a day time brace, which can be effective up to the age of three years.
All children with significant angular deformity (stage III-V) should be considered for orthopedic surgery by osteotomy with an internal and/or external fixation device. If performed at an early stage, the surgeon will usually obtain complete and permanent correction of the child’s limb deformity, whereas there is a greater chance for recurrence if osteotomy is done in later years.

 Possible post-surgical complications

Bone lengthening and deformity correction can come with a few possible complications. The most common are the following:

  • infection – for instance, with an external fixation device it may occur at the pin and wire sites (which must be constantly cleaned for prevention), or in the bone (which is extremely rare);
  • delayed or too fast bone healing;
  • implant related complications;
  • nerve or blood vessel injuries;
  • muscle stiffness and joint contracture;
  • bent or broken bones;
  • blood clots in the leg;
  • allergies to some medications, or anesthesia.

Ask your doctor or orthopedic surgeon to explain all the possible post-surgical complications and how they can be prevented. Do not hesitate to contact her/him whenever you have any doubts or questions.

What can happen if a bone deformity is not corrected in time?

If left untreated, or not treated in time, bone deformity can deteriorate with age and lead to major complications. While growing, your child will gain weight, which adds extra stress to his/her joints. The bone deformity can become permanent and in time your child can develop osteoporosis, with further reduction of the mobility and more fragile bones. There can also be increased severe functional and aesthetic problems, nerve damage and pain.

Ask your doctor or surgeon to explain all the possible complications if your child’s bone deformity is left untreated. Contact her/him for any doubt or question you may have.

 

 

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Treatments Conditions Parents

What is Arthrogryposis Multiplex Congenita?

`Arthrogryposis is a non-progressive – it does not worsen over time – disorder that is present at birth, involving many muscle and tendon shortenings that limit joint movement. It occurs in approximately 1 out of 3,000 births (0.03%), and can affect all four limbs, or upper or lower limbs only.

Arthrogryposis causes

It is present at birth and the exact cause is unknown.

Arthrogryposis symptoms

Muscles and tendons are shortened, so the limbs may be stuck in one position. The child’s limbs are often thin, with weakened muscles and abnormal joints resulting in, among others, knee contractures and foot conditions.

Arthrogryposis diagnosis

A doctor will perform an examination, taking into account the symptoms and their appearance. If more information is needed, imaging tests – such as X-ray, CT scan or MRI – may be performed, along with more specialized tests, like muscle or skin biopsy, blood tests and nerve tests.

Arthrogryposis treatment options

Arthrogryposis can be treated with joint manipulation, orthotics and casting, particularly in the first few months of life. For correction of severe and ongoing deformities, surgery may be required. Surgery can be as simple as releasing the Achilles tendon or the use of an external fixation device, which may be required for realignment and to lengthen limbs that have contractures.

Arthrogryposis multiplex congenita complications

Proper treatment helps improve the range of motion and your child’s ability to use their limbs, although there is no way to completely fix arthrogryposis. Depending on the severity of the condition, people with arthrogryposis may have few physical limitations after treatment, while others who are more severely affected may live with discomfort and lack of mobility, and require physical assistance for daily activities.

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Treatments Conditions Parents

What is Genu Valgum?

Genu valgum, also known as knock knees, may be a passing trait in children. It can be seen in children from 2 to 5 years old and is often naturally corrected as children grow. When knock knees are severe, there can be strain on the knee, which results in pain.

What causes genu valgum?

Genu valgum can be passed down through genes, or it can happen because of injury, infection or a problem with metabolism that has affected the bones. It can be caused by poor nutrition – by obesity and, less commonly, by severe calcium and vitamin D deficiencies.

Genu valgum symptoms

When standing, your child’s knees will touch or be closer together than the ankles, pushing the ankles further apart. Knock knees can cause pain, discomfort, a limp or difficulty walking.

Genu valgum diagnosis

An orthopedic specialist will look at the legs to see if the angle is not in a normal range. An X-ray of the knee may be needed to confirm the severity of knock knees.

Genu valgum treatment methods

This deformity can sometimes be managed with noninvasive methods, such as limits on activity, nonsteroidal anti-inflammatory drugs like ibuprofen, braces, exercise programs and physical therapy. When these methods don’t work, surgery may be needed. Osteotomy (the surgical cutting or removal of a piece of bone) and correction with external fixation is a useful way to support and straighten the limb in the management of genu valgum. Guided growth may be a good treatment in some cases.

Genu valgum complications

If untreated, the symptoms can worsen, causing pain, problems with movement and even arthritis.

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Treatments Conditions Parents

What is Genu Varum?

Genu varum, or bowlegs, may present at any time from infancy through adulthood. It can affect one or both legs. Medical and genetic history may help doctors understand how the condition will progress and for how long. As genu varum becomes more severe, the patient may start to waddle and have discomfort while walking. In children up to 2 years old, painless bowing on both sides may occur and often fixes itself over time.

What causes genu varum?

Genu varum is normal in the very young and may happen in older children due to rickets and Blount’s disease, or because of bone problems, infections or tumors.

Genu varum symptoms

One or both legs may show bowing, often just below the knee, even when the ankles are together. It may progress rapidly and unevenly.

Genu varum diagnosis

An orthopedic specialist will look at the legs to determine how far they bend inward and will confirm the diagnosis with an X-ray of the knee.

Genu varum correction treatment options

Bow-leggedness that causes problems and does not fix itself will be seen in X-rays and may need treatments, including surgery. Physical therapy exercises, special shoes and limits on standing and activity may be needed before or after surgery. Guided growth may be the best genu varum treatment to help straighten the limb. In certain cases, genu varum treatment with osteotomy (the surgical cutting of a bone or removal of a piece of bone) and an external fixation device is necessary.

Genu varum complications

If severe bow-leggedness is not treated, the symptoms can worsen, causing different leg lengths, pain and difficulties with mobility.

The condition can come back after surgery, especially in younger children, who are still growing. An orthopedic specialist can help you determine the right time to perform surgery.

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Treatments Conditions Parents

What is Rickets?

Rickets is a condition that softens, distorts and weakens bones in children. As late as the 1940s rickets was a very common childhood ailment.

Rickets causes

A lack of vitamin D or calcium is the most common cause of rickets in children. Among the genetic rickets causes – those that cannot be fixed simply by changing diet and nutrition – the most common is X-linked hypophosphatemic rickets, which happens in 1 out of 20,000 newborns (0.01%). Other genetic causes are very rare.

Rickets symptoms

Children with rickets may suffer from bone pain, bones that break easily, stunted growth, muscle cramps and bone deformities such as bow-leggedness (genu varum), and spinal deformities.

Rickets diagnosis

Blood tests can diagnose rickets disease and an X-ray may be needed to understand the extent of bone deformities. Bone density scans may be needed to see how severe the disease is.

Rickets treatment options

In case of deficiencies, the first line of rickets treatment is to add vitamin D and calcium to the diet, to let the body fix any bone problems itself. However, rickets disease caused by a genetic condition may need additional medicines and surgery. In less-severe cases, a brace can be used on the spine or limbs to support the bones as they grow.

In more severe cases of limb deformity, gradual osteotomy (the surgical cutting or removal of a piece of bone to change how bones line up) and the use of an external fixation device can be used to both support and reshape the limbs as they grow and get stronger. Guided growth with small plates can be used to correct deformities.

Rickets disease complications

If untreated, rickets can lead to very stunted growth, dental problems and seizures. Bone problems need to be treated to prevent pain and issues with mobility.

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Treatments Conditions Parents

What is Clubfoot?

Clubfoot is diagnosed when a baby’s foot is twisted down and in. Usually present at birth, infant clubfoot occurs in about 1.3 out of 1,000 births (0.13%) and is usually an isolated problem for an otherwise-healthy baby. About half of children with clubfoot have the condition in both feet.

Infant clubfoot causes

The cause is at least partly genetic, because it is known to run in families. Otherwise it is not known, but it might happen when muscles are not even in the lower leg.

Infant clubfoot symptoms

In clubfoot, the top of the foot usually twists down and in. The arch is high, and the heel also turns in. In more-severe cases, the foot might actually look upside-down. Even though clubfoot may shorten the foot and affect normal growth of the calf muscles, clubfoot itself doesn’t actually cause discomfort or pain.

Infant clubfoot diagnosis

A doctor can usually diagnose infant clubfoot based on how the foot looks after birth or sometimes also during routine ultrasound scans during pregnancy. In some cases, an X-ray may be needed to determine the severity of the condition.

What are clubfoot treatment options?

Clubfoot hinders normal walking so treatment should begin soon after birth. The most common clubfoot treatment method involves stretching and casting (to hold the new position of the foot), performed repeatedly over several months, followed by minor surgery to lengthen the Achilles tendon under local anesthetic (Ponseti method). Stretching and use of special shoes and braces may be needed for up to three years after the surgery. Most children treated this way will have pain-free, normal-looking feet that function well.

However, severe clubfoot that has not gotten better with stretching and casting may need surgery and possibly the use of an external fixator, which can be used to help reshape muscles and other soft tissues over the course of several months to one year. In most cases, babies who are treated early are able to wear ordinary shoes and participate in normal activities when they are older.

Clubfoot complications

Even after clubfoot treatment, once your child starts to stand and walk, mobility may be slightly limited. In addition, shoe sizes may differ between the clubfoot and the unaffected foot. If left untreated, your child is likely to have a lack of normal muscle growth, arthritis, inability to walk normally and, perhaps, self-esteem issues related to how the foot looks.

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Treatments Conditions Parents

What is Blount’s Disease?

Blount’s disease, also known as tibia vara, is a condition in which growth does not occur normally in the growth plates of the lower leg, resulting in deformities that may differ in direction and severity. Severe bowing of the legs can result, causing pain and mobility issues. It is different from physiological bow legs, which tend to straighten as the child grows. Your doctor will be able to tell you which one your child is experiencing.

Blount’s disease causes

The cause of tibia vara is not certain, but it seems to be associated with early walking and above-average weight, and may be caused by the effects of weight on the growth plates. There is a genetic element and some patient groups seem more likely to develop Blount’s Disease.

Blount’s disease symptoms

One or both legs may show bowing, which typically occurs just below the knee and may progress rapidly and unevenly.

Blount’s disease diagnosis

An orthopedic specialist will examine the legs to determine the inward-bending angle and will confirm the diagnosis by performing an X-ray of the knee.

Can Blount’s disease be cured?

In younger children and less severe cases, a corrective leg brace or orthotic may be used to manage the limb deformity. Another option is a minimally invasive orthopedic surgical procedure to insert a guided growth plate system. This inhibits the bone growth on one side of the deformity and allows the opposite side to catch up, straightening the leg.

In more severe deformities, an osteotomy may be required. After osteotomy, either an external or internal fixation device will be used to hold the new bone in place.

What are Blount’s disease or tibia vara complications?

If Blount’s disease is not treated, the symptoms can get worse, causing different leg lengths, pain and trouble walking. The condition can come back after surgery, especially in younger children, who are still growing. An orthopedic specialist can help you determine the right time to perform any surgery.

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Treatments Parents

How to correct bone deformity?

When a limb needs to be lengthened, or a bone needs to be corrected, there are several orthopedic non-surgical and surgical treatments available, depending on the severity of the issue and the patient’s medical history. Your doctor or orthopedic surgeon will carefully evaluate what is appropriate for the case considering your child’s age, her/his medical history, the physical examination, imaging, and blood and/or nerve tests.

What is the most common bone deformity surgical treatment?

The most common surgical method to treat bone deformities consists of carefully cutting the bone on purpose and then lengthening or correcting the limb. This corrective procedure, called osteotomy, may be performed with either internal or external fixation devices (more rarely together) to stabilize the cut bone.

Orthopedic internal fixation allows to correct the bone deformity all at once. The surgeon will operate your child under general anesthesia, and will apply metal rods, screws or plates – that will remain in place under the skin after orthopedic surgery – to adjust the bones.
Orthopedic external fixation, with metal rods or pins located outside the limb, is recommended in case of a quite complex bone deformity, which cannot be repaired using open reduction with an internal fixation device, and which is safer to correct gradually, avoiding injury to soft tissues such as nerves or blood vessels.

How can a bone deformity be corrected with an orthopedic external fixator?

An external fixation device allows the new bone to strengthen and harden while growing in the new shape/length. To achieve the bone deformity correction, the external fixator needs gradual adjustments to help the new bone tissue to grow into place over time. When the orthopedic surgeon is happy with the bone’s length, shape and alignment, adjustments will no longer be needed. However, your child will still wear the external fixator, which will support the limb while the new bone tissue hardens and the limb becomes stronger (Bone healing process). These two phases – the “correction” and “consolidation” steps together – usually last from 4 to 12 months.

At the end of the bone fracture healing process, the external fixator will be removed. Your child may need to wear a cast for a short while after the fixator frame has been removed.

What is a hexapod-based system?

A hexapod-based system is a new and advanced method for bone deformity correction. It combines two parts: hardware and software. The hardware is made of metal rings that are anchored to the bone by screws and wires. The software incorporates imaging to determine the precise measuring and positioning of the fixator and allows for its simultaneous adjustment at multiple angles. This innovative system lets children with bone injuries/deformities receive customized care that can optimize clinical, aesthetic and functional outcomes.

How can a bone deformity be corrected with guided growth plates?

In children, bone deformity can gradually be corrected by stapling one side of the growth plate. By doing this, one side of the growth plate is harnessed, while the other side goes on growing. As soon as the bone is straight, the staple can be removed to allow symmetric development of the whole growth plate. This orthopedic surgical technique has the advantage to be minimally invasive and it is often performed on an outpatient basis.

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Parents Conditions

What is a bone deformity?

A bone deformity is an atypical, structural deviation or distortion of the bone’s shape from its normal alignment, length and/or size. A bone deformity can be congenital or acquired.

What causes bone deformities?

Children’s bones grow and reshape themselves continually and extensively. Growth proceeds from a very vulnerable part of the bone named the growth plate (What’s the difference between Kid bones and Adult bones?). While reshaping and remodeling, old bone tissue is replaced by the new one, and many bone disorders and/or deformities come from these changes. This type of deformity is called developmental – caused by the changes that occur in a growing child’s musculoskeletal system. These deformities may get better or worse as children grow.

Bone deformities can also be:

  • Congenital – they are inherited, sometimes related to specific pathologies.
  • Post-traumatic – they occur after accidents and injuries, when the bone heals in a deformed position.
  • For unknown reason – they just happen. In this case they are called idiopathic.

How many types of bone deformity are there?

There are four main types of bone deformity:

  • a bend in the bone – called “angulation”
  • a twist in the bone – called “rotation” or “torsion”
  • a shift in the position of the bone caused by a fracture or by osteotomy – called “translation” or “displacement”
  • a difference in the length of a bone compared with the contralateral – called “limb length discrepancy”.

All these different types of bone deformity can exist on their own, but it is common to find a combination of them.

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Treatments Parents Bone Fractures

How to provide first aid treatment for a bone fracture?

In case of bone fracture, you should:

  • Call immediately for medical care.
  • Keep your child still and calm.
  • Do not move your child in case of head, neck, back, pelvis or hip injury.
  • Support the injured limb with a pillow or sling.
  • Check your child’s airway or breathing.
  • If skin is broken, it should be treated to prevent infections. If possible, rinse the wound gently to remove visible dirt and cover with sterile dressing.
  • If needed, immobilize the broken bone with a splint: these may include a rolled-up newspaper, cardboards or strips of wood. Immobilize the area both above and below the injured bone.
  • Apply ice packs wrapped in cloth to reduce pain and swelling.
  • Prevent your child’s shock. Lay her/him down, if possible, with elevated limb about 12 inches-30 centimeters higher than the heart.
  • Do not move your child in case of head, neck, back, pelvis or hip injury.
  • Treat bleeding by placing a dry clean cloth over the wound to dress it.
  • Pain relief may be needed and medication may help to reduce pain. Follow dosage instructions given by your doctor.

In case of bone fracture, you shouldn’t:

  • move your child unless the broken bone is stable;
  • move a child with a suspected injured spine, head, neck;
  • move a child with injured hips, pelvis or upper leg, unless absolutely necessary;
  • attempt to straighten a bone;
  • apply heat in any form, since it increases swelling and pain;
  • allow your child to eat anything, in case surgery is needed.

Which are the exams for a correct diagnosis?

X-rays are generally used to diagnose the type of bone fracture and whether or not the bones are in line (if there is a displacement or not). Although X-rays reveal most fractures, including subtle fractures in skeletally immature children, in some cases (e.g. occult physeall fracture) the fracture detection may be improved by using magnetic resonance imaging (MRI) or computed tomography (CT or CAT scan).

Does physiotherapy help my child’s bone fracture healing?

Physiotherapy exercises are very important for your child’s limb healing. Physiotherapy makes sure that his/her bones are surrounded and supported by healthy, strong muscles, and his/her joints continue functioning well to prevent permanent joint stiffness. Exercises must be constantly practiced under the supervision of a qualified physiotherapist.

Useful resources to help bone health

The two most important lifelong bone health habits are proper nutrition – a varied and balanced diet with the right amount of essential elements plus calcium and vitamin D – and physical activity. One of the best ways to encourage healthy habits in your children is to be a good role model yourself. Children watch us, and our habits have a strong influence on theirs.

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Treatments Parents Bone Fractures

Types of bone fractures in children

There are several types of bone fractures that may occur in children, including:

  • Greenstick or Buckle – an incomplete fracture in which the bone bends or buckles without completely breaking; frequent in small children.
  • Open (or Compound) – the fractured bone breaks the skin.
  • Closed (or Simple) – the fractured bone doesn’t break the skin or outer tissues.
  • Comminuted – a fracture of three or more relatively small fragments.
  • Displaced – the bone cracks completely in many pieces that move out of alignment.
  • Transverse – a fracture that goes across the bone’s axis.
  • Spiral – a fracture that runs around the axis of a bone.
  • Oblique – a fracture that goes at an angle to the axis.

What are the most frequent bone fracture treatments?

The most frequent bone fracture treatment options are the following:

  • Splint or Plaster Cast.
  • Open reduction with internal fixation (ORIF).
  • Open reduction with external fixation (OREF).
  • Closed reduction with external fixation (CREF).

The needed treatment will depend on the type of bone fracture.

What are the main differences among these bone fracture treatments?

  • Splint and Casting are non-surgical options. Splints are mostly used in cases of incomplete fractures and casts are used for closed, standard fractures. Always follow your doctor’s instructions completely.
  • Open reduction with internal (ORIF) or external fixation (OREF), and more rarely together, are options that require orthopedic surgery. ORIF is a recommended surgical procedure in case of complicated bone fractures not able to be realigned (reduced) by casting, or in case the long-term use of a cast is not desirable or indicated. The orthopedic surgeon will operate while your child is under general anesthesia, and will apply metal rods, screws and/or plates to repair the bones that will remain in place under the skin after surgery. OREF is a surgical procedure that involves the use of an external fixation device to support the bone and hold it firmly in the correct position while it’s healing. The orthopedic fixator is connected to the bones with bone screws, commonly called pins, and will be removed when healing is achieved. OREF is recommended in case of quite complex fractures that cannot be repaired using open reduction with an internal fixation device.

Who decides the best treatment options?

The treatment your child needs will depend on the type of fracture, age, overall health and medical history of your child. Each child is different and your orthopedic surgeon – a doctor specialized in conditions related to bones health, ligaments, tendons and muscles – will discuss with you the necessary and best treatment for your child’s bone fracture. Your orthopedic surgeon will also share with you your child’s recovery plan and will be with you along the entire treatment to ensure the treatment is proceeding as intended.

What to expect after surgery with an external fixator?

In case your child’s limb has been realigned with the use of an external fixator, your orthopedic surgeon will give you an estimate of how long your child’s recovery will take, as it depends on many factors: type of bone fracture, child’s age, overall child’s health and other co-factors. During the healing process, it’s important that your child stays active and starts mobilizing as soon and safely as possible: playing, going back to school, keeping up his/her daily routines. When back home, your child should meet other children and friends, enjoying their company to overcome the initial stress and limitations, and always following the instructions provided by the surgeon and hospital staff.

In case of treatment with orthopedic external fixator, why is pin-site care so important?

The pin-site is the area of skin crossed by pins or wires of the external fixator: it has to be checked carefully every day and kept constantly clean to prevent infections of your child’s limb. It’s very important that you follow exactly the instructions provided by your orthopedic surgeon and hospital staff.

How long does an external fixator stay on?

The hardware will be removed from your child’s limb when the orthopedic surgeon is completely satisfied with the alignment and consolidation of the bone. Your child might need to wear a cast for a short while after the fixator frame has been removed.

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Parents Bone Fractures

Bone fracture healing: how does it work?

Let us start from the basics: what are bones made of? The main component of a bone is bone matrix, which is a mixture of a fibrous protein called collagen and an inorganic compound mostly made of calcium and phosphate. All bones have an outer surface called periosteum, a very thin membrane with nerves (that feel pain) and blood in it. The compact bone is the smooth and very hard part of the bone; it’s what we see when looking at the skeleton. The spongy bone is lighter than the compact bone, but still very strong. The inside of a bone is hollow,and filled with a jelly called bone marrow.

What’s the difference between kid bones and adult bones?

  • Your baby has tiny hands, little feet, small limbs and an overall tiny body. As he/she grows up, everything becomes gradually bigger, including his/her bones. An infant has about 300 bones at birth; while growing, they fuse together to form the 206 bones that an adult has. Some of your baby’s bones are totally made of a special, soft and flexible material called cartilage; some others are partly made of cartilage. Cartilage is replaced by hard bone matrix as the bones reach their full size. By the time he/she is about 25 years old, this process will be complete and the bones are as big and long as they will ever be. All together they form a skeleton that is light but also strong and very resistant.
  • Children have open growth plates (called epiphysis) located at the end of the long bones. This is the area where the bone grows. Injury to the growth place can cause limb length discrepancies or angular deformities.
  • Small children are more likely to have incomplete fractures, that go partially through the bone, because their soft bones – which are still growing – often bend or buckle instead of completely breaking.

How are bones classified?

The bones of a human skeleton are classified in two major types: the axial skeleton and the appendicular skeleton. Put simply, the axial skeleton includes the bones of the head and torso, and the appendicular skeleton means the appendage or limb bones. Axial skeleton has about 80 bones and appendicular skeleton has 126 bones. The main functions of the skeleton are to give shape to our body, provide attachment for muscles and produce red blood cells.
The longest, largest and hardest bone is the thigh bone, also known as Femur:

  • it is located between the knee and the hip;
  • it makes up one-fourth of an individual’s overall height;
  • it is a weight-bearing bone;
  • it is very light in weight, but it is considered stronger than concrete;
  • it is connected with the hip by a ball and socket joint that allows for freedom of movement.

How many types of bones are there?

There are 5 types of bones in the human body:

  • Long bones provide length to the body, support weight, facilitate movement and provide shock absorption (g. Femur, Humerus and Tibia).
  • Short bones provide support and stability with little movements (g. Carpals, Tarsal, Metacarpal, Metatarsal, Phalanges).
  • Flat bones provide protection to our vital organs and are a base for muscular attachment (g. Scapula, Sternum, Cranium, Pelvis and Ribs).
  • Irregular bones protect the internal organs and have a complex shape (g. Vertebrae, Sacrum, Mandible).
  • Sesamoid bones are short and irregular bones that provide protection to tendons (g. Patella “the knee cap”, Pisiform).

How do fractures heal?

Fractures heal at different rates, depending on the age of the child and type of fracture, but in general a child’s bone heals faster than an adult, due to some differences in the bone structure. In children the periosteum is thicker, stronger and more active to better supply oxygen and nutrients to the growing bones, and this helps rebuild the bone in case of fracture. Its inner part contains very vital cells able to produce new bone.

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Parents Bone Fractures

What is a bone fracture?

A bone fracture is a medical condition in which a bone is cracked or broken. If too much pressure is put on a bone than it can stand, it will split or break. If the broken bone pokes through the skin, it is called an open or compound fracture. In children, incomplete fractures are frequent, in which the bones bend or buckle instead of break. The most common bone fractures affect long bones (such as humerus, ulna, radius, femur, tibia and fibula).

How to know if a bone is broken?

Sometimes it is hard to tell a dislocated joint from a bone fracture, but generally you can recognize different signs of a broken bone:

  • An out-of-place, deformed or misshapen limb or joint
  • Swelling, sometimes bleeding
  • Bruising, warmth or redness
  • Severe pain
  • Tingling and numbness
  • Broken skin with bone protruding
  • Limited mobility or inability to move the limb.

What are the most common causes of a bone fracture?

The most common causes of a bone fracture are falls, injuries or accidents.
Fractures are very common in childhood, as children play games and sports, jump, ride bicycles, run down the stairs, and so on. But some children have an inherited condition called osteogenesis imperfecta that makes their bones more fragile and susceptible to breaking. Also, neuromuscular disorders, renal diseases, diabetes and growth hormone deficiency may raise the risk of bone fracture in children.

How do I know when my child is in pain?

Your child may self-report pain, or you can observe it through her/his behavior. Signs of pain include persistent crying, the inability to move or bear weight on the affected limb, fainting, and unconsciousness. In all cases, try to reassure your child and keep her/him still and calm. If you suspect a fracture seek medical help immediately.

Who can help us in case of bone fracture?

Seek medical care right away if you suspect your child has a broken bone.

If you believe your child has injured his/her head, neck or back, keep your child lying down until medical help arrives. Don’t allow your child to eat anything in case surgery is needed.

If the injury is to a limb, you can apply a cold compress or an ice-pack wrapped in cloth. Do not apply ice directly on the skin. If you’re dealing with a limb injury, leave the injured limb in the position you find it. It can be necessary to cut clothing off with scissors to prevent your child from having more unnecessary pain. You can place a soft padding around the injured part, and something firm (e.g. a board or rolled-up newspapers) next to the injured part, and long enough to go past the joints and below the injury. Fix it loosely with first-aid tape or wraparound bandage until medical care arrives. Again, don’t allow your child to eat anything in case surgery is needed.

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Physical Educators

Common sports injuries in children

Common sports injuries in kids and teens are classified into 3 types: acute injuries, overuse injuries, and reinjuries.

Acute injury in children

Acute injuries in children are usually associated with some kind of trauma.

In young children, acute sports injuries can include minor bruises, sprains, and strains.

Teenagers are more likely to sustain more severe injuries, including broken bones and torn ligaments, concussions, skull fractures, spinal cord injuries and eye injuries – scratched corneas, detached retinas and blood in the eyes.

Overuse injuries in sports

Overuse injuries in sports are generally caused by repetitive actions that put too much stress on the bones and muscles. Although this can happen in adults too, they’re more problematic in young kids because they can affect growth.

Common types of overuse injuries include:

  • Knee overuse injuries: pain in the front of the knee under the kneecap. The knee will most likely be sore and swollen due to tendon or cartilage inflammation. The cause is usually muscle tightness in the hamstrings or quadriceps, the major muscle groups around the thigh.
  • Swimmer’s shoulder: inflammation or swelling of the shoulder caused by the repeated stress of the overhead motions used when swimming or throwing a ball. The pain usually begins intermittently but may become continuous pain in the back of the shoulder.
  • Shin splints: characterized by pain and discomfort on the front of the lower parts of the legs. Shin splints are often caused by repeated running on a hard surface or overtraining.
  • Spondylolysis: lower back pain that results from constant overextension, which puts stress on the bones of the lower back. It is commonly seen in kids who play soccer and football, or practice gymnastics, wrestling and diving.
  • Tennis elbow (or “Golfers elbow”) depending on the involved ligament: caused by repetitive throwing, it can result in pain and tenderness in the elbow. The ability to flex and extend the arm could be affected, but the pain typically happens after the follow-through of the throw. Besides pain, pitchers sometimes complain of loss of velocity or decreased endurance when playing.

Reinjury

Reinjury can happen when an athlete returns to a sport before a previous injury has properly healed. Doing so places excess stress upon the injury and forces the body to compensate for the weakness, which can put the athlete at greater risk for injuring another part of the body.

You can avoid reinjury by giving it time to completely heal. Once the doctor has approved a return to the sport, make sure that a child in your care properly warms up and cools down before and after any exercise. Try re-entering the sport gradually. Explain that easing back into the game at a sensible pace is better than returning to the hospital!

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Physical Safety Educators

Preventing children sports injuries

Sports are a great way for children to burn off excess energy, practice teamwork and communication skills, and stretch their limits, but any sport carries the potential for injury.

Younger children have undeveloped coordination and can have slower reaction times than adults because they are still growing. As they grow, the potential for injury increases due to the amount of force they are able to apply when participating in sports.

Following these simple rules can help reduce children sports injuries:

Use of proper sports equipment

Make sure any safety gear used is the correct size and that all sports equipment carries your country’s official standards accreditation.

Adult supervision

A qualified adult or coach with the correct training and qualifications should always supervise any sport. Be sure you can clearly see children while they are playing sports.

Proper preparation

Drinking plenty of water and warming up is important before playing any sport. Teaching children to properly warm up at a young age can help reduce sports injuries throughout their life.

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Physical Educators

What are the signs of a concussion?

A concussion is an injury to the brain that results in temporary loss of normal brain function. Concussions happen when someone receives a blow to the head and/or the brain is shaken excessively. Symptoms of concussion may include:

  • headache or a feeling of pressure in the head;
  • temporary loss of consciousness;
  • confusion or feeling of “brain fog”;
  • amnesia surrounding the traumatic event;
  • dizziness or “seeing stars”;
  • ringing in the ears;
  • nausea;
  • vomit.

Concussion in kids is a serious event and must be treated with the utmost care, seeking a medical professional’s advice immediately.

Sports related concussions

Sports related concussions in kids are quite common. All sports carry a certain amount of risk, but some of them present greater risks, including:

  • Mountain biking
  • Football
  • Ice hockey
  • Lacrosse
  • Rollerblading
  • Rugby
  • Soccer
  • Snowboarding

Nothing can prevent a concussion, but wearing the correct safety gear helps protect against severe head trauma. Repeated concussions in kids can lead to lasting brain damage. In addition to wearing the correct equipment, awareness of symptoms and aftercare is very important.

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Physical Safety Educators

Playing safely to prevent playground injuries

Letting your child run around outside in the fresh air is great for their growth and development. Playgrounds are great fun, but it is very important to check that the area and equipment are safe for your child.

Every year, more than 220,000 kids under age 14 are treated in the hospital for playground injuries. Although minor bumps, bruises or cuts occur on playgrounds often, some other more severe injuries – broken bones, concussions, dislocations and internal organ injuries – are the most common playground injuries that require a doctor’s immediate care.

Parents and educators can make the playground safer for kids, including adult supervision, ensuring that equipment is free of potential hazards and steering children to age-appropriate play areas.

Here are a few other tips on how to prevent playground injuries.

Supervise children while playing

Kids can be fearless and often don’t know yet what their limits are. Supervise them at all times. Supervision won’t prevent all injuries, so if first aid is needed, administered it right away.

Safety of the children’s playground

Always check that playground surfaces are clean and clear of any obstructions before letting a child play.

Regarding surfaces, some things need to be considered: safer surfaces include wood chips, mulch, sand, pea gravel. Rubber mats made of compliant materials can also provide a safe surface to play. Rubber mats can provide the best access for people in wheelchairs.

Design and spacing of children’s playgrounds

Children’s playground equipment should be appropriate for the age of the user.

Play areas for younger children should be separated from those meant for older kids with signs to locate each area clearly. Children shouldn’t play in an area not designed for them.

Here are some things to look for when assessing children’s playground equipment:

  • swings, seesaws, and other equipment with moving parts should be located in an area separate from the rest of the playground and swings should be limited to 2 per bay;
  • baby swings with full bucket seats should have their own bay;
  • swings should be spaced at least 24 inches apart and 30 inches between a swing and the support frame;
  • guardrails and protective barriers should be in place for elevated surfaces, including platforms and ramps;
  • climbing nets should have openings that are either too small to allow a child’s body through or large enough to prevent entrapment of the head;
  • look out for ‘pinch points’ on playground equipment with moving parts, anything that a child could get their limbs caught in.

Maintenance and inspection tips for a playground

  • There should be no broken equipment, wooden equipment should not be cracking or splintering, and metal equipment should not be rusted
  • The fence surrounding a public playground should be in good condition to prevent kids from running into surrounding traffic or busy areas
  • Surface materials on the playground should be maintained to minimize tripping hazards
  • Children’s playground equipment should be made of durable materials that won’t fall apart or be damaged by the weather
  • Check for objects like loose screws/bolts that stick out on equipment and could cut a child or cause clothing to become entangled
  • Check for debris in sandboxes and be sure that the sand is free of bugs. Sandboxes should be covered overnight to prevent contamination from animals
  • Keep the area the way you would like to find it. Pick up trash, use the equipment properly, and report any problems to the organization that is responsible for maintenance of the playground.

Teaching kids about playground safety to prevent injuries

Children’s playgrounds can be a great place for kids to socialize with their friends when supervised correctly. Follow these safety tips to ensure children you are supervising play safely and avoid injuries.

Teach children to:

  • never push or play too rough when using playground equipment;
  • use the equipment correctly – slide feet first, don’t climb outside guardrails, no standing on swings;
  • land on both feet if they are going to jump off equipment or slide;
  • playground surfaces may be slippery when wet;
  • during summer, check all playground surfaces (especially metal) as they can get very hot from the sun;
  • wear sunscreen, even on cloudy days, to avoid sunburn;
  • avoid clothes with drawstrings or long ties as these can become trapped and can cause injuries.
Categories
Physical Safety Educators

Safe cycling to prevent injuries

Riding bikes is not only fun but also a great way for children to exercise. Bike safety is very important. 6 percent of fatal injuries and 6 percent of non-fatal injuries occur during the journey to or from school. The most common types of injuries are bruises and scrapes, followed by bone fractures involving upper extremities (36%) and lower limbs (25%), and head and neck (15%).

Here are a few tips regarding helmet basics, safe clothing, bike safety and bike maintenance.

 

Kids bike helmet basics to reduce head injury

The single most effective safety device available to reduce head injury – including the risk of permanent brain damage – and death from bicycling is a helmet. All of us – not just children – should wear a bike helmet when cycling, regardless of age or skill level.

  • Any bike helmets made before 1999 must be replaced
  • When purchasing new kid bike helmets, make sure they have the correct safety stickers attached for your country
  • Picking bright or fluorescent colors that are visible to drivers and other cyclists is a great idea
  • Look for a helmet that’s light, well-built and well ventilated
  • Ask a bike shop for help finding a helmet that is the correct size for your child and fitted properly
  • If the kids bike helmet is dropped or damaged it must be replaced

 

Ware safe bike clothing to reduce injuries

  • Bright colors over dark colors – Fluorescent or brightly colored bike riding clothes will help kids be visible on the road
  • Reflective is best – Wear something that reflects light like reflective tape or hi-vis vests
  • Be breathable – Lightweight bike riding clothes will help avoid overheating
  • Prevent avoidable accidents – Trousers should not be too loose fitting and all loose straps should be tied up. Anything that can get caught up in the chain while riding should be secured
  • Correct footwear – Choose shoes that grip the bike’s pedals and never ride barefoot

 

What should I teach children about bike riding safety?

  • Stop at all stop signs and obey traffic lights just as you would if you were in a car. Stop for pedestrians, stop at red lights and be especially careful at intersections and junctions.
  • Always check in both directions when setting off on your bike, regardless of where you are.
  • Never ride against traffic.
  • Don’t cycle too closely to parked cars – doors can open suddenly and cause injury.
  • Use bike lanes or designated bike routes if you can – not the sidewalk or path!
  • Avoid riding in the dark if you can help it, as people won’t be able to see you. If you have to, make sure you are wearing reflective bike clothing and a light.
  • Be sure to walk a bike across busy roads using the crossings and follow traffic signals.
  • Always ride single file on the street when in a group – this helps cars pass safely.
  • Never share the seat with a friend or ride on the handlebars – this is not safe at all!
  • Never wear headphones while cycling – you need to hear what’s going on around you at all times.
  • Never stand up while riding your bike.

Always use the correct hand signal and look behind you before changing lanes:

Left turn: hold your left arm straight out from your side and ride forward slowly

Stop: bend your elbow, pointing your arm downward in an upside down “L” shape and
come to a stop

Right turn: hold your right arm straight out from your side and ride forward slowly.

How to maintain a bike:

Be sure to always check:

  • Brakes – check for worn out cables and pads and replace them
  • Chain – keep your chain grime free and be sure to lubricate it regularly to avoid rust
  • Handlebars – adjust for height of children to prevent accidents or injuries
  • Seat – keep the seat level and adjust the height as needed, making sure that the child can reach the pedals comfortably when sitting
  • Tires – check the correct pressure on the side of the tire before setting off. If it is too low it can be too difficult to ride; moreover, it can cause damage to the bike wheels
  • Bike bell – check if it works correctly
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Children Teenagers Videos Children Parents Videos Educators Videos Teenagers Educators Videos Parents

Why Do I Need Surgery?

Bone fractures, regeneration and healing; growth plates (epiphysis); length discrepancy and bone deformity; the role of the orthopaedic surgeon

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Children Teenagers Videos Children Parents Videos Educators Videos Teenagers Educators Videos Parents

The Human Skeleton

The basic of the human skeleton, its main functions and skeletal development.

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Emotional Physical Teenagers Treatments

Life with a fixation device

During your treatment, there may be a few things that you can’t do, but you will find out soon that your orthopedic fixation device doesn’t interfere too much with your normal life. Your orthopedic surgeon will explain the schedule for adjustments, how to clean the pin sites, and will plan some visits to check how it’s going. Your doctor will give some instructions regarding weight bearing and mobility. At the beginning, you may need a wheelchair and/or crutches. Your physiotherapist will tell you how to use them. As soon as your fixation device is no longer needed, it will be removed easily, probably in an out-patient setting.

How will the fixation device affect my daily life? 

Try to live your daily life as always: see friends, get out, do things you enjoy – this is very important for your treatment and successful recovery. It may be useful to plan ahead when visiting places, finding out, for instance, where the disabled access is, if toilets are accessible, and look for transports to get you there and back. A few things may only be more challenging with a fixator, some others are simply not allowed for your safety.

What is not recommended to do with a fixation device?

Driving a car. No driving is allowed until you can fully bear weight and you are relatively pain free. If your external fixator is on an upper limb, no driving is allowed if the external fixator bridges the wrist and/or you have a poor grip strength in either hand. Please ask your orthopedic surgeon and care team and discuss the possibility of driving with your insurance company.

Having sex without covering the fixation device. Your fixator frame should not stop you having normal relationships. You could cover the frame with a soft cloth to protect your partner’s skin.

Carrying items. It can be useful to use a cross body bag or a rucksack for carrying a bottle or other items. Some people attach a shopping bag onto walking frame handles.

Tight-fitting clothes. You may need to buy clothing a few sizes bigger than usual, choosing nice looking track pants with buttons and zips. Girls could also wear long, fashionable skirts. For ankle frames, there are special boots that are adjusted to fit the frame allowing for comfortable walking.

What is the fixator’s impact on sport and physical activity?

After surgery you will have limited motion and you won’t be allowed to bear weight for a certain number of days or weeks, according to your orthopedic surgeon and care team instructions. Nevertheless, nowadays teen patients tend to quickly return to independence and sports activities.

Here are some tips for your recovery:

Physiotherapy. Refer to your physiotherapist’s instructions regarding the quantity of physical activity and the type of exercises you should perform on a regular basis. Following his/her instructions is extremely important to ensure you get the maximum benefits of surgery and external fixation.

Swimming and hydrotherapy. Swimming in public pools, in the sea/ocean or in rivers should be avoided as any dirt or sand could increase the risk of infection. Hydrotherapy is fine as long as all your pin-sites are clean and healthy.

Stretching and strengthening exercises will ensure you can move the way you want to after the fixation device comes off and leaves you with improved energy.

Keep active. Go to the movies, eat out, attend your favorite sport matches and visit with family and friends. At the beginning, you may feel uncomfortable with people looking at your external fixator but try not to let it bother you and remember why you are doing this.

How can I talk about orthopedic treatment with my friends?

You should return to school as soon as possible once you are mobile, according to your surgeon and care team instructions. Show people – neighbors, friends, schoolmates and teachers – your orthopedic external fixator and explain to them how it works and why it is there. You could prepare your return to school by meeting your teachers in advance, sharing your feelings and concerns and telling them your special needs.

How to deal with my worries?

Talk to your parents and friends about your feelings and worries. Do not hide or ignore them. You should ask your orthopedic surgeon any question you have regarding your fixation device, your healing process and your future. Check with your surgeon and your care team to see if a psychological service is available in the hospital and seek for counselling if you feel the need for it.

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Emotional Teenagers Health and Prevention

Technology, social media and sleep problems

Using technology at night has been proven to affect people’s ability to fall asleep. By limiting the use of your gadgets at night, you can fall asleep faster and get a better quality sleep.

Here are some tips that should make it easier to reduce your technology use before bedtime and improve sleep quality:

  1. Log off your messaging apps, social media and email. Any messages that come through can wait until the morning.
  2. Leave devices in a different room. By leaving your smartphone in another room and switching off electronic devices, things such as blinking lights and glowing screens won’t distract you or prevent you from falling asleep.
  3. Stop using electronics an hour before bed time. Putting your phones and electronic devices down an hour before bed helps you switch your brain off. Getting good sleep is the only way to be refreshed and focused during the day.

Try these tips and you will see your sleep quality improve!

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Physical Teenagers Health and Prevention

What is the key to maintaining a healthy weight?

Maintaining a healthy weight requires regular exercise and good eating habits. The key to working these into our lives is by making small changes that gradually become part of our routine.

After orthopedic surgery, your range of motion and ability to weight bare will be limited. It is important that you follow your orthopedic surgeon’s instructions during this critical period.

Following your doctor’s instructions is extremely important to ensure you get the maximum benefits of orthopedic surgery and external fixation. Eventually you should be able to add exercise to your routine. To maintain a healthy weight, follow these simple tips:

Exercise regularly

60 minutes or more of physical activity a day is recommended to maintain a healthy weight. There is no need to do complicated exercises or overthink it; the goal is just to keep your body moving. Practicing flexibility, strength and light cardio should be more than enough.

60 minutes out of your busy day may seem like a lot, but think about it in simple terms: try getting up 15 minutes earlier to do some yoga or other stretching activities. Walk to school or jog for 15 minutes at lunch. Do the same thing after school, or walk or cycle home. Add in taking the stairs, fitness classes, walking between classes during the day, and you’ve probably reached your 60 minute target to maintaining a healthy weight without really stepping out of your routine.

Here are some tips to get 60 minutes of exercise a day:

  1. Start now. Walk to school instead of driving or taking the bus.
  2. Take the stairs instead of the lift/elevator or escalators.
  3. Walk or cycle to places like school or your friends’ houses instead of driving or taking public transportation.
  4. If you drive, park farther away than you need to and walk the extra distance.
  5. Everyday chores can be an exercise opportunity!
  6. Limit your online social networks & digital activities. By cutting this time down you will find more time to exercise.
  7. Dance. Even in the privacy of your room, you will burn more than 300 calories in an hour dancing!
  8. Find an exercise you like. Take it slow if you’ve never done it before. And if you’re nervous, find an exercise buddy to join you. It’s easier to stay motivated about exercise if you do something you’re interested in with a friend.
  9. Mix up the activities you do, so they will never bore you. Create a list of sports you have always wanted to try and work your way through them with a friend.
  10. Include some activities that get your heart beating faster, quicken your breathing and make you sweat.

Eat healthy

Eating healthy doesn’t have to be boring and you don’t have to be on a strict diet to lose or maintain a healthy weight. Diets aren’t sustainable, but eating good food in moderation as part of a healthy lifestyle is. The best way to maintain healthy weight (or lose weight when needed) is to make healthy food choices daily and incorporate them as part of a long-term routine.

Here are some tips for daily healthy eating:

  1. Drink water instead of sugary drinks like fruit juices, energy drinks, and soft drinks.
  2. Fruit and vegetables are a must! Make sure you eat at least five servingsof fruit and vegetables a day, possibly of 5 different colors. This will fill you up and you’ll get the nutrients you need to keep your body satisfied and healthy.
  3. Choose food from all the different food groups – fruit and vegetables, grains, including whole grains, protein and dairy. In addition to getting your fruit and veggies, include whole grains and lean protein at each meal.
  4. Avoid fast-food places whenever you can. Treats are allowed every now and then, but if you are going to fast-foods more regularly, pick a small serving and a salad instead of fries.
  5. Keep healthy food at hand. By carrying around fruit and nuts as snacks you are more likely to avoid things like crisps/chips and chocolate.
  6. Avoid processed food by taking your own homemade food with you to school.
  7. Eat when you’re hungry but don’t fall into the trap of eating when you’re bored.
  8. Have a healthy breakfastevery morning. It is the most important meal of the day.
  9. Manage portion sizes: if a portion is too large, cut it in half and put half aside for later.
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Treatments Teenagers Health and Prevention

Why you should quit smoking

It can be extremely hard to quit smoking and it takes daily commitment. Nicotine is a powerfully addictive drug. It takes about one month for the nicotine cravings to subside, but with the right help and information you can quit. Reprogramming your brain takes time. You’ll need patience and willpower. It’s best to take it one day at a time.

Remind yourself of these reasons to quit smoking:

–   you will feel healthier and less out of breath;

–   your skin will look healthier;

–   you will save a lot of money;

–   smoking prolongs bone, fracture and wound healing times.

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Physical Teenagers Health and Prevention

How to keep good hygiene

Puberty causes changes in your body. Every day it seems you have new hair growing in different places. At times, you seem to sweat for no reason, and you may notice there are odors where you never had them before. These changes are a normal part of becoming an adult, but some of them can be a real source of anxiety. What should you do about it in order to stay hygienic?

Oily/Greasy hair treatment. Each strand of hair has its own oil (sebaceous) gland, which keeps the hair shiny. During puberty, the sebaceous glands produce extra oil, which can cause hair to look very greasy. Washing your hair at least every other day with specially formulated shampoo can help control any oil, but be careful not to scrub your scalp too hard – this doesn’t get rid of oil any better and can irritate your scalp. Be careful not to use any styling products that will add extra grease to your hair.

Sweat and body odor in puberty. Perspiration, or sweat, comes from sweat glands that you’ve always had in your body. Thanks to puberty, these glands become more active than before; they also begin to release different chemicals into the sweat that has a stronger odor. You might notice this odor in your armpits. Your feet and genitals might also have new smells.

Here are tips for good hygiene:

  1. Shower every day. This will help wash away bacteria that contributes to body odor. If you are wearing an orthopedic external fixator you will be allowed to shower about 10 days post-surgery. Go slow, no rush. Dry off carefully using a clean cotton towel. Pay attention not to alter the different elements of the external fixator.
  2. Use an alcohol-free deodorant for your underarms and feet.
  3. Wear clean clothes, socks and underwear each day.
  4. Wear cotton – preferably T-shirts, socks and underwear.

Body hair growth. Discovering hair in new places is perfectly normal during puberty. You may want to start shaving some places where body hair grows, but whether you do is entirely up to you. You can use a traditional razor with a shaving cream or gel to protect sensitive skin, or you can use an electric razor. Wherever you shave, do it slowly, take your time and change razors often to avoid nicks. Your parents or an older sibling can be very helpful when you’re learning how to shave, so don’t be afraid to ask for help or do research. In the rare case where excessive body hair growth is enough to cause anxiety (e.g.hirsutism), a dermatologist or skin specialist can use permanent removal techniques such as electrolysis or laser removal.

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Physical Teenagers Health and Prevention

How to get better quality sleep

Sleep is important for both your brain and your body. It is during sleep that your body spends its time healing, but many teens struggle with getting the 8-10 hours of sleep each night as recommended.

Sleep affects how well you can focus at school, your emotions, your health and your weight. Although there are medical treatments for serious sleep issues, there are things you can do at home to help improve your sleep quality. Below are a few tips on how to get better quality sleep:

Be more active – Whether it be walking to and from school or playing a sport during your lunch break, try to get around 60 minutes of physical exercise a day. This will help decrease stress and relax your body and mind.

Avoid alcohol and drugs – As well as being proven to increase anxiety in some people, alcohol and drugs disrupt your sleep pattern, increase your chances of waking up in the middle of the night and make it harder to get back to sleep.

Social media shutdown – Switching off all your electronic devices or just not using them an hour before going to bed will help your brain relax before it’s time to sleep.

Create a sleep routine – Turn off electronic devices, shower or take a bath, brush your teeth, read for 30 minutes or write in your diary. Anything that helps you wind down before bed is helpful.

Expect a good night’s sleep – Stress triggers insomnia, so the more you worry about not sleeping, the greater the risk you’ll lie awake. It can also help to practice breathing exercises before bed to feel more relaxed.

These are excellent solutions to improve sleep quality. Try it yourself!

What causes sleep problems?

Nightmares. Nightmares are normal and happen to everyone, but frequent nightmares can disrupt sleep by waking someone during the night. The most common triggers for nightmares are stress or anxiety, but also things such as certain medicines, and consuming drugs or alcohol. Sleep deprivation can also lead to nightmares, so it’s important to give yourself at least the recommended 8 hours of sleep per night.

Narcolepsy. Narcolepsy is troublesome because people fall asleep without any kind of warning, making it hazardous to do things like drive. School, work and social life can be affected by unusual sleep patterns. Narcolepsy isn’t commonly diagnosed in teens, but many cases go unrecognized. People have symptoms between the ages of 10 and 25, but may not be properly diagnosed until 10-15 years later. Narcolepsy can be treated with medication and lifestyle changes. If you find yourself having hallucinations, feeling overly sleepy during the day and/or having memory problems, then it’s best you tell your parents of your concerns.

Obstructive Sleep Apnea. A person with obstructive sleep apnea temporarily stops breathing during sleep because their airway becomes narrowed or blocked. The most common cause of obstructive sleep apnea in a teenager is enlarged tonsils or adenoids (tissues located in the passage that connect the nose and throat). Being overweight or obese can also put you at risk. People with this disorder may snore, have difficulty breathing, and sweat during sleep. People who show signs of obstructive sleep apnea should talk to their doctor.

PLMD and RLS. People with periodic limb movement disorder (PLMD) or restless legs syndrome (RLS) find that involuntary leg or arm movements disrupt their sleep, leaving them tired and irritable from lack of sleep. PLMD includes involuntary twitches or jerks: they’re called involuntary because the person isn’t knowingly causing it and is often unaware of the movement. RLS is an actual physical sensation in the limbs, such as tingling, itching, cramping, or burning. The only way they can relieve these feelings is by moving their legs or arms to get rid of the discomfort.

Reflux. In gastroesophageal reflux disease (GERD), stomach acid moves backward up into the esophagus, producing a burning sensation we know as heartburn. GERD symptoms can be worse when lying down.

Sleepwalking. Sleepwalking in teenagers tends to happen when a teenager is sick, has a fever, is not getting enough sleep, or is feeling stressed. It’s not usually a serious problem. Sleepwalkers tend to go back to bed on their own and don’t usually remember sleepwalking. Sometimes sleepwalker will need help moving around obstacles and getting back to bed. Waking sleepwalkers can startle them (but it isn’t harmful), so try to guide a sleepwalker back to bed gently.

What happens during sleep?

While you’re asleep, your brain is still active. As we sleep, our brains pass through five stages. Stages 1, 2, 3, 4 and REM (rapid eye movement) sleep make up a sleep cycle. One complete sleep cycle lasts about 90 to 100 minutes. During an average night’s sleep, a person will experience about four or five sleep cycles.

Stages 1 and 2 are periods of light sleep where it’s possible to wake up easily: eye movement slows down and eventually stops, your heart and breathing rate also slow down, and body temperature decreases.

Stages 3 and 4 are deep sleep stages: it’s more difficult to wake up, and if awakened a person will often feel groggy and confused. They are the most refreshing of the sleep stages – it’s this type of sleep that we crave when we are very tired.

The final stage of the sleep cycle is called REM sleep because of the rapid eye movements that occur during this stage. During REM sleep, other changes take place – breathing becomes rapid, the heart beats faster, and the limb muscles don’t move.

Why do I have trouble sleeping?

Studies have found that teens’ brains are more active later in the evening, which is why so many find it hard to sleep earlier in the evening. During adolescence, the body’s circadian rhythm (the internal biological clock) is reset, telling a teen to fall asleep later at night and wake up later in the morning. This change in the circadian rhythm seems to happen because a teen’s brain makes the hormone melatonin later at night than the brains of kids and adults. Because a teenager’s melatonin is made later at night, teens have a harder time falling asleep earlier in the night. Sometimes the delay in the sleep-wake cycle is so severe that it can affect daily activities, and it’s called delayed sleep phase syndrome or ‘night owl’ syndrome. Teens can suffer from insomnia from time to time. The most common causes of sleep problems are stress and a poor sleeping environment where the bedroom is too cold, hot or noisy. Poor diet and exercise can also be contributing factors.

Chronic insomnia is insomnia that lasts longer than a month, and can be caused by other different issues, including medical conditions, mental-health problems, side effects of medication or substance abuse. Worrying about the insomnia can make it worse. A brief period of insomnia can build into something that lasts longer when a person becomes anxious about not sleeping or worried about feeling tired the next day. Doctors call this psychophysiologic insomnia.

What can I do to prevent my sleep problems?

If you regularly have sleep problems, talk to your parents and see your doctor to find the best solution for your issue. You may need to visit your doctor if you think you are getting enough rest at night, but you still feel tired during the day.

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Physical Children

What is a pediatric orthopedic surgeon?

A pediatric orthopedic surgeon is a specialized doctor who has chosen to make the care of children and their bones – from infancy through the teenage years – the focus of his/her medical practice. Some conditions he/she can treat are the following:

  • Limb and spine deformities noted at birth or later in life (such as clubfoot, scoliosis and limb length differences, to name a few)
  • Gait abnormalities (limping)
  • Bone and joint infections or tumors
  • Broken bones.

Why do I need a pediatric orthopedic specialist?

Children are not just small adults. Your growing bones are living tissues that change continuously and pose different challenges than those of adults. Adopting healthy nutritional and lifestyle habits are important choices to build healthy bones and prevent osteoporosis and fragility fractures later in life. The healthy habits that you adopt during your childhood and adolescence can literally make your bones stronger as you age. Some common pediatric problems don’t occur in adults, and what looks like a problem in a child may be just a variation that you will outgrow over time.

Nevertheless, some other bone disorders need an accurate orthopedic specialist’s evaluation and may require bracing or surgical intervention. Some bone disorders can be inherited, or caused by injuries, infections, poor blood supply or tumors. They can cause painless bone deformities and affect your ability to walk and use the limb.

Treatments depend on the disorder but often surgery may help, as it can put back in the right place your displaced bones before the cast, the splint or brace is put on. The orthopedic surgical procedure is called reduction which means “setting the bone”.

Pediatric orthopedic surgeons, their supporting staff and their offices are all well equipped to deal with you and your family, in order to share the problem, decide the best treatment strategy and offer you a comfortable, patient-focused and family-friendly environment.

Questions to ask your pediatric orthopedic doctor:

  • Does my condition require a doctor with specialty training?
  • May I need some professional counseling to go through the treatment?
  • Is it safe for me to exercise, run and jump?
  • Is it safe for me to swim?
  • How long should I rest during the day?
  • Is there anything that I should avoid doing?
  • Will this condition cause me any long-term problems?
  • What can I do to facilitate my bone’s healing process?
  • How can I talk about the treatment with teachers and friends?
  • Should I take calcium supplements?
  • Does a steroid medication for asthma affect my bone’s healing process?
  • How long will the treatment last?
  • Are there any tools to help me understand the treatment?
Categories
Physical Treatments Children

What am I allowed to do with an external fixator applied?

When you leave the hospital, your bone fracture will go on healing thanks to the external fixator applied by your pediatric orthopedic surgeon. You are on the road to recovery and normal life! At home, you might experience some pain and discomfort, and this is likely due to being more active at home than in the hospital. It could help to rest your limb on a pillow or, if pain persists, to take a painkiller following your doctor’s prescription.  Wearing an external fixator can limit your mobility, but it’s just a matter of time before it will be removed.

At home try to keep as many daily routines and social activities as possible – you will discover that your external fixator doesn’t interfere too much with them. At first, you’ll be walking with crutches. A wheel chair can help you get around at home and you could turn this into a game!

Why not pretend you’re a robot or a super hero? Your fixator could be part of your armor! But remember: be patient and don’t give up. Slow down a bit and take one step at a time.

When the healing phase is complete, your pediatric orthopedic surgeon will decide to remove your external fixator. After the fixator has been removed, you may need to wear a cast for a short time. Why don’t you ask your parents to organize a party with your friends to celebrate the end of the treatment and your return to ‘real’ normal life?

Here are a few tips to be shared with your parents.

Do’s

Talk to your parents and your orthopedic surgeon if you feel pain or discomfort. They will help you.

Elevate your affected limb when resting. Try to keep it above the level of your heart.

Move your toes or fingers frequently to reduce swelling.

Ask your parents to apply ice to reduce swelling.

Collaborate with your parents in inspecting the skin at the pin sites and look for any change in color, temperature, odor or texture.

Collaborate with your parents in cleaning pin sites daily as instructed by your orthopedic surgeon and care team.

Do physical therapy as instructed by your physiotherapist to ensure that strong muscles are surrounding your bones and your joints keep functioning as they should.

Eat healthy to accelerate the healing process and give your body the fuel it needs.

Don’ts

Don’t put full weight on your orthopedic fixation device at first. Over time, as your leg becomes stronger, your surgeon will instruct you to put more weight on it.

Don’t get your fixator wet until cleared by your surgeon.

Don’t use objects such as pencils, rulers or toothbrushes to scratch around fixator or pin sites.

Don’t alter your orthopedic fixation device in any way.

Don’t try to remove your external fixator by yourself.

Categories
Physical Treatments Children

What am I allowed to do after the orthopedic plates and screws have been applied?

Finally, you’re back home! You might feel some pain, swelling or discomfort. Don’t worry, it’s normal. Your bone fracture was repaired thanks to the application of plates and screws used in orthopedic surgery. It might help to rest your limb on a pillow, and this will probably reduce your pain. If it’s not enough, don’t be afraid to tell your parents. They may have something else that can help you – an analgesic, for instance.

You may need crutches at first, but it shouldn’t be long before you’re able to move again without them. It’s important that you listen to your doctor’s instructions and parents’ advice: it will help you get better faster.

From the outside, people won’t see that you have orthopedic plates and screws healing your bone fracture. Imagine it like a secret superpower! You can decide who to tell that you have it… Choose wisely!

If you are scared about what you can or can’t do, just ask your parents and your doctor. It’s   important to ask any questions you may have and share with them how you feel.

Here are a few tips to be shared with your parents. Always follow the instructions of your pediatric orthopedic surgeon.

Do’s

Rest when you feel tired.

Prop up your injured limb and ask your parents to put ice on it when it’s swelling or painful. Try to keep it above the level of your heart.

Get enough sleep. It helps you to recover faster.

Increase your mobility as recommended by your orthopedic surgeon, care team and/or physiotherapist. Being active boosts your blood flow and helps prevent pneumonia and constipation.

Collaborate with your parents in keeping your incision clean and covered.

Pay attention to any nasty odor. It could be a sign of infection. Inform your parents about it.

Eat what you like but remember to include vegetables and fruit every day.

Do exercises as instructed by your physiotherapist.

Dont’s

Don’t put on weight on the injured limb at first. Always follow the instructions of your pediatric orthopedic surgeon and physiotherapist.

Don’t shower for 1 or 2 days after surgery. When you do it, keep your incisions and dressing dry. If you have a cast, tape a sheet of plastic to cover it so it does not get wet.

Do not take a bath or a soak; do not swim until your incision is healed. This will usually take 1 to 2 weeks.

Don’t ignore fever. A high temperature could indicate an underlying condition that requires medical attention. Inform your parents about it.

Categories
Children Teenagers Parents Activities Children Educators Activities Educators Activities Parents

The Kids Box

The decision to have surgery is a big one for a child. Our goal is to provide tools – apps, comic strips, kids box with games and coloring books – to amuse and entertain your kid, particularly in the early post-operative phase, when he/she is not allowed to walk yet. We know it is very important for children to stay active and be positive when in the hospital and back home after hospital discharge. Our “Kids box” also has an educational goal: while playing and having fun, your child will understand something more about the orthopedic fixator applied on his/her limb. Kids will learn how to live with the fixation device and how to take care of it. They discover which kind of movement is suggested and what is better to do for their health and faster healing. While relaxing, the youngest children will learn how the human body works, what a bone is made of and how to feel comfortable with their new medical device. They will also learn how to communicate when they feel stressed or uneasy.

Memory Game

This game is designed to keep your child busy when not allowed to walk.
Cut out the cards and start to play.
Players: 1 or 2.
Goal: Collect the most matching pairs.

1. Shuffle the cards.
2. Lay out all the cards face down in rows, on the table or floor.
3. Decide who will go first.
4. The first player chooses a card and turns it over. If the two cards are a matching pair, then the player takes the two cards and starts a stack. The player is awarded another turn for making a match and goes again. If the cards are not a match, they are turned back over and it is now the next players turn.
5. The game continues in this way until all the cards are played. The player with the most matching pairs is the winner.

Memory Game Download link:
Download

Your Dancing Skeleton

Use this game to teach your child the name of the bones and the functions of the different body parts.

Cut out along the dotted lines. Glue or staple or use paper fasteners to put the skeleton back together.

Alternatively, you can use it as a competition game, to keep your child busy. If you have a board game at home with dice, use the dice to play the skeleton game.

1. Make several copies of this sheet.
2. Cut out the pieces and place them in the middle of the table.
3. Decide who will go first.
4. The first player rolls and then play continues clockwise:
a. For a 6, take a skull.
b. For a 5, take a body.
c. For a 4, take a humerus or a forearm.
d. For a 3, take a femur or a tibia.
e. For a 2, take a hand.
f. For a 1, take a foot.

5. First player to complete the skeleton is the winner.

Your Dancing Skeleton Download link:
Download

Complete the picture

Describe to your child how the limb will change after the treatment and what he or she will be able to do differently.

Draw and color the missing part of the body and the background scenery.

Complete the picture Download link:
Download

Which one doesn’t belong?

Use this picture to check out with your child what is needed for the daily pin-site care.

Circle the items that are not useful in cleaning the fixator of the baby raccoon.

Which one doesn’t belong? Download link:
Download

How Does It Feel?

Use this set of cards as a simple puzzle of facial expressions. Teach your child to label and communicate emotions and feelings.

Cut out along the dotted lines. Piece together the cards to put the face back together. How does the animal feel?

How Does It Feel? Download link:
Download

Categories
Children Teenagers Parents Activities Children Educators Activities Educators Activities Parents

How Does It Feel?

Use this set of cards as a simple puzzle of facial expressions. Teach your child to label and communicate emotions and feelings.

Cut out along the dotted lines. Piece together the cards to put the face back together. How does the animal feel?

How Does It Feel? Download link:
Download

Categories
Children Teenagers Parents Activities Children Educators Activities Educators Activities Parents

Complete the picture

Describe to your child how the limb will change after the treatment and what he or she will be able to do differently.

Draw and color the missing part of the body and the background scenery.

Complete the picture Download link:
Download

Categories
Children Teenagers Parents Activities Children Activities Educators Educators Activities Parents

Your Dancing Skeleton

Use this game to teach your child the name of the bones and the functions of the different body parts.

Cut out along the dotted lines. Glue or staple or use paper fasteners to put the skeleton back together.

Alternatively, you can use it as a competition game, to keep your child busy. If you have a board game at home with dice, use the dice to play the skeleton game.

1. Make several copies of this sheet.
2. Cut out the pieces and place them in the middle of the table.
3. Decide who will go first.
4. The first player rolls and then play continues clockwise:
a. For a 6, take a skull.
b. For a 5, take a body.
c. For a 4, take a humerus or a forearm.
d. For a 3, take a femur or a tibia.
e. For a 2, take a hand.
f. For a 1, take a foot.

5. First player to complete the skeleton is the winner.

Your Dancing Skeleton Download link:
Download

Categories
Children Teenagers Parents Activities Children Activities Educators Educators Activities Parents

Memory Game

This game is designed to keep your child busy when not allowed to walk.
Cut out the cards and start to play.
Players: 1 or 2.
Goal: Collect the most matching pairs.

1. Shuffle the cards.
2. Lay out all the cards face down in rows, on the table or floor.
3. Decide who will go first.
4. The first player chooses a card and turns it over. If the two cards are a matching pair, then the player takes the two cards and starts a stack. The player is awarded another turn for making a match and goes again. If the cards are not a match, they are turned back over and it is now the next players turn.
5. The game continues in this way until all the cards are played. The player with the most matching pairs is the winner.

Memory Game Download link:
Download