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Paediatric Orthopedics and Rheumatology

Treatments & Procedures

Here are some of the conditions treated in this department: Ataxia Telangiectasia, Blount's Disease, Bowlegs, Brachial Plexus Injury, Calcium and Bone Disorders, Clubfoot, Developmental Dysplasia of the Hip, Fracture, Growth plate injuries, Hip Dysplasia, Hyper-Lordosis, Kyphosis, Legg-Calve-Perthes Disease, Marfan Syndrome, MCL Injuries, Meniscal Cartilage Tears, Metabolic Bone Disease, Neurocutaneous Syndromes, Neurofibromatosis, Osgood-Schlatter Disease, Osteochondritis Dissecans, Osteogenesis Imperfecta, PCL Injuries, Rickets, Scoliosis, Slipped Capital Femoral Epiphysis, and Stress Fracture.

Spasticity Management

Our specialists work to manage children's symptoms of spasticity and dystonia. The treatment of spasticity and dystonia is complex and has changed considerably over the past few years. Through this center, a team of physicians, therapists, and other healthcare professionals discuss treatment alternatives and choose the best option for the child. This allows for the integration of information from multiple disciplines when developing a treatment plan for the child.

Pediatric Bone Health

The Center for Pediatric Bone Health was developed with a goal to identify and treat bone diseases and osteoporosis in children. Osteoporosis does not only affect maturing adults. Children who are immobile because of severe neuromuscular conditions have a higher risk of developing osteoporosis.The center also evaluates pateints with a variety of conditions, classified by their level of bone density. These include: Osteopenia, Osteogenesis Imperfecta (OI) and frequent fractures. Treatment options may include: nutritional diet incorporating calcium and other vitamins, physical therapy and surgery.

Pediatric Rheumatology

The Pediatric Rheumatology Division at KIMS is devoted to the complete care of children with rheumatic disease. In conjunction with our multi-disciplinary therapeutic team of specialists, we treat children with a variety of rheumatologic conditions including: Juvenile Idiopathic Arthritis (JIA), Systemic lupus erythematosus and Juvenile dermatomyositis.

Through early diagnosis and appropriately intensive treatment, we aim to control the disease process as quickly and safetly as possible with the ultimate goal of returning children to full physical functioning if possible. Treatment options may include: Methotrexate, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Prednisone.

Scoliosis and Spine Disorders The KIMS Joint Diseases Center for Children utilizes minimally invasive and state-of-the-art techniques to achieve the best cosmetic and functional outcomes in children and adolescents with scoliosis and other spine disorders.

Sports Injury

Over the past several decades, the number of children participating in sports has dramatically increased. Unfortunately, this has been accompanied by a rise in sports-related injuries such as fractures, dislocations, ligament and cartilage injuries, shin splints, and concussions. Sports-related injuries are the second leading reason for emergency room visits as well as the second leading cause of injuries in school. At KIMS, our specialists provide comprehensive care of sports-related injuries for youths including the complete evaluation, diagnosis, and treatment of young patients with sports injuries.

Cerebral Palsy and Neuromuscular Disorders

The Cerebral Palsy and Neuromuscular Clinics are conducted at KIMS. These clinics are multidisciplinary and our focus is to improve patient outcomes with treatment for conditions such as cerebral palsy, spina bifida, and muscular dystrophy. What is unique to our center is that our children are assessed on an individual basis for their needs and issues by our team. Outcome measures, including questionnaires and other assessment tolls, are utilized to best determine plans of treatment, both operative and non-operative.

Clubfoot and foot deformities

Clubfoot is a congential deformity of the foot, which affects more boys than girls and occurs during the first trimester of pregnancy. Clubfoot patients' feet are pointed downwards and curved inwards. While this condition does not cause pain, it progressively becomes worse if left untreated and may permanently cripple the infant. All modalities of treatment are used, depending on the type of clubfoot being treated. Treatment may be initiated by parental consultation with the staff following the diagnosis of a clubfoot in utero (by ultrasound), or after birth and continue through childhood, adolescence, and to adulthood in the case of persistent clubfoot problems. Treatment may include:

  • Lowa-Ponseti Technique
  • Posterior foot release
  • Posteromedial foot release
  • All inclusive posteromedial and lateral releases, including plantar release
  • Progressive soft tissue releases
  • Tendon transfers
  • Osteotomies of the food and leg (in the older child)
  • External fixation to correct deformity (in the older child); may be of Russion (Ilizarov), Italian, or American variety (EBI)

All clubfeet are classified according to type and children may be evaluated by other disciplines such as genetics and developmental pediatrics. When necessary, braces or orthoses for daytime and nighttime use are ordered for clubfoot patients. All children with clubfeet are followed until maturity and through adulthood.

Hip Pain

Surgeons at KIMS have performed hundreds of hip preserving procedures such as the Pericacetabular Osteotomy (POA) for hip dysplasia for young patients. Hip dysplasia is a very common cause of hip arthritis that often goes undiagnosed into adulthood. The patient often presents with hip pain that worsens with activity and tends to worsen in severity over a period of years. Diagnosed correctly as a shallow hip socket (acetabular dysplasia), the patient can undergo a POA often alleviating the pain. This procedure helps also to protect the hip from further arthritis thereby delaying or eliminating the need for future hip replacement.At times, the diagnosis in our young athletic population may be a torn labrum or hip impingement. These can often be treated with less invasive procedures like hip arthroscopy. Hip arthroscopy is an outpatient procedure that places a camera within the hip joint allowing torn structures or impinging bone to be repaired or removed.When a hip relplacement is needed other members of the team use the most advanced techniques, such as anterior approach and resurfacings, and materials, such as ceramics and metals, to create a result with the least amount of recovery time and the greatest longevity of the new hip as possible.

Pediatric Rehabilitation

Our goal is to treat, assist, and encourage children with severe orthopaedic and neurological conditions to reach their highest functional capacity, specifically their motor, intellectual, and social skills. This specialty center evaluates patients for their individual needs relating to equipment, bracing, physical and occupational therapy, and psychological needs.

Pediatric Psychology

We offer outpatient evaluations and treatment to children and adolescents with a broad range of diagnoses including cerebral palsy, neuromuscular/orthopaedic conditions, spina bifida, and other chronic illnesses.

Pediatric Neurology and Neuromuscular Medicine

We offer expertise in the diagnosis and management of various neuromuscular disorders including: Muscular dystrophies, e.g. Duchenne Muscular Dystrophy/Becker Muscular Dystrophy, myotonic dystrophy, facioscapulohumeral dystrophy, limb-girdle muscular dystrophy, etc; Congenital myopathies; Hereditary neuropathies, e.g. Charcot-Marie-Tooth Disease; Myasthenia gravis; Spinal muscular atrophies and other causes of hypotonia and muscle weakness. Our Pediatric Neurologist is board certified in both Neuromuscular and Electrodiagnostic Medicine and has many years of experience conducting pediatric EMG-NCV studies. In addition to the treatments offered by these specialty clinics, we also provide care for a variety of other neurological disorders, including developmental delays, autistic spectrum disorders, chronic headaches, seizure disorder, spina bifida, and arthrogryposis.

Thoracic Insufficiency and Early Onset Scoliosis

Chest wall deformity and early onset scoliosis in children can cause thoracic insufficiency syndrome (TIS), which is an inability of the thorax to support adequate lung growth and function. Causes of TIS include congenital scoliosis and syndromes such as Jeune's, Jarcho-Levin, and spondylocostal dysplasia. A multi-disciplinary team approach help provide optimal care for this complex patient group. At KIMS, our team consists of experts within the fields of Pediatric Orthopaedics, Pulmonology, Pediatric Thoracic Surgery, Pediatric Radiology, Pediatric Anesthesia, Pediatric Critical Care, General Pediatrics, Nutrition, Social Work, and Nursing that work closely together to provide exceptional care.

Limb Deformity/Length Discrepancy

KIMS provides state-of-the-art techniques in a setting for children and adults with limb length inequalities and upper and lower extremity deformities. The goal of the institute is simple: to improve function, decrease disability, and prevent or at least delay arthritis in children. A team consisting of pediatric orthopaedic surgeons, anesthesiologists, pain management doctors, pediatricians, and nurses help ensure that patients receive the best care possible for their complex conditions.

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