Definition and Overview
Orthopedic disorders are those that affect the musculoskeletal system, which is made up of bones, muscles, ligaments, and joints. Also known as orthopedic birth defects, congenital orthopedic problems occur while the baby is still developing in the womb and thus already appear at birth.
These congenital birth defects are caused by a wide range of possible factors such as gene abnormalities and toxin ingestion or disease and illness during pregnancy. They occur in different types and may be characterized by different symptoms. Some of them may not require treatment and may heal or improve as the child grows, while some may put the child at risk of complications when left untreated.
Causes of Condition
Congenital orthopedic problems begin while the baby is still in the uterus; when certain factors cause the bone and muscle tissue to develop abnormally. However, the majority of orthopedic birth defects don’t have obvious causes but there are some risk factors, such as:
- Hereditary abnormal genes
- Chromosomal disorders
- Taking medications that are ruled as harmful during pregnancy
- Consumption of alcohol
- Smoking or exposure to cigarette smoke
- Taking illicit drugs
- Exposure to radiation
- Exposure to certain chemicals
- Infections that affected the mother during pregnancy, including German measles or chicken pox, among others
- Pre-existing diseases affecting the mother such as diabetes, heart disease, hypertension, or thyroid disease, to name some
- Incorrect position of the infant in the womb
Regardless of the cause, most congenital orthopedic problems are diagnosed using x-rays, imaging scans (such as ultrasound, CT scan, and MRI scan), or a biopsy of the bones and muscles so that they can be examined under a microscope to check for possible signs of a disorder. Some blood and urine tests may also be performed to try and determine whether there is an infection or enzyme problem involved. For some conditions, such as muscular dystrophy, an electromyogram (EMG) or an electrocardiogram (EKG) may also be performed.
Nowadays, it is also possible to conduct a genetic testing to check for abnormalities either before birth (during the pre-natal stage) or right after birth.
The symptoms of congenital orthopedic problems differ depending on the specific type of disorder involved. These disorders and their corresponding symptoms may vary in severity, from mild to severely debilitating.
The most common types of congenital orthopedic defects include:
- Clubfoot – This is considered as the most common orthopedic birth problem, and is a deformity that affects the foot. An infant with this condition has a shorter and broader foot that is abnormally curved in.
- DDH or developmental dysplasia of the hip, which is simply described as dislocated hip
- Osteogenesis imperfect – Also known as the brittle-bone disease, this condition places patients at risk of breaking their bones even with a mild injury.
- Scoliosis or curved or twisting spine
- Kyphosis or bowed spine
- Muscular dystrophy – This refers to a group of congenital disorders rather than just a single one; the disorders all have one thing in common – the child’s muscles are weaker than normal and may easily break down.
- Limb defects or missing limbs – These occur when one or several of the limbs do not develop properly.
- Metatarsus adductus or curved foot – This is a condition wherein the front half of the foot is curved in. It may occur due to the infant’s position in the uterus during the crucial stages of development.
- Bone infection
Most of these birth defects cause visible problems affecting the spine, legs, feet, arms, or hands. Some, however, especially when the problem is mild, may not be readily noticeable and may only become more pronounced as the child grows. For example, a child suffering from a congenital birth defect that is unnoticed at first may be unable or find it difficult to walk despite reaching the proper age or may be less mobile than other kids his or her age.
Also, some congenital orthopedic problems may not be visible but may be discovered after the child suffers severe injury from a minor fall, which is a common occurrence among children suffering from brittle bones.
Who to See and Types of Treatments Available
There are many treatment options for children suffering from orthopedic birth defects. The most appropriate will be chosen based on their specific condition, age, and overall health status.
The most common treatment options include:
- The use of orthopedic devices – These include braces, splints, and casts, and their purpose is to help move the bones and joints slowly to their proper position or alignment.
- Physical therapy – The purpose of physical therapy is to improve the child’s range of motion and to slow or counter the progress of the problem.
- Occupational therapy – For defects that cannot be treated, the patient may undergo occupational therapy to help him learn how to do normal activities despite his condition. The purpose is to help him live as normal life as possible, training him in eating, walking, getting dressed, and caring for himself.
Surgery – Only used in severe conditions and when the birth defect is life-threatening, surgery allows orthopedic specialists to adjust the bones, muscles, and tendons into their proper position or alignment. However, patients undergoing surgery as well as their parents, if they are minor, are informed of the risks of surgery prior to the operation. As a general rule, surgery should only be performed if the benefits outweigh the risks.
Pediatric Orthopedic Society of North America (POSNA)