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Feet, Leg and Hip Conditions in Children

 
  Source: Article first appeared on SingHealth - Bones & Joints: What you need to know (Jul 2009)  
     
 

Is your child's orthopaedic problem worrying you?

Conditions of the feet

Many parents are concerned with the normal development of their children’s feet making them amongst some of the most common conditions that doctors see. Some may be part of growing up and will usually self-correct. Others require treatment that may range from something as simple as special shoes to surgery.

Some of the more common conditions of the feet that we see are:

  • Flatfeet
  • Clubfeet
  • Abnormally shaped feet
  • Curly toes
  • Ingrown toenail
  • Extra or missing toes
  • Lumps and bumps over the foot
  • Foot pain

A doctor will be able to help differentiate between these conditions and advise treatment in a timely manner.

Conditions of the legs

Parents have many queries on whether the way the child walks is normal and if the placement of the feet during walking is normal. Some of these variants in walking patterns can be part of development yet some may be a sign of growth abnormalities. The way the leg aligns can also vary with age. But if the alignment is abnormal, early treatment may be required.

Some of the more common conditions of the legs are:

  • Bowleggedness
  • Knock knees
  • Unstable walking
  • Walking on the toes (tiptoeing)
  • Unequal leg lengths

Conditions of the hips

Limping is a very common observation in children. Most times, limps are due to excessive activity and do resolve on their own. But at other times, depending on the age of the child, limping more often than not is usually secondary to problems in the hips.

Other than limping, hip conditions can present with different patterns of walking such as in-toeing and out-toeing. These patterns can be a result of normal development or it can be due to some underlying abnormality.

Newborns are also screened for a condition where the hip may be poorly or under developed or even dislocated. This is called Developmental Dysplasia of the Hips. It is important to diagnose this condition early, as treatment is simple in the early stages, requiring braces or casting. If the chance for early treatment is missed, these children may require more invasive methods such as surgery to remedy it.

Some of the hip conditions that are seen are:

  • Developmental dysplasia of the hips
  • In-toeing
  • Out-toeing
  • Painful and painless limps in different age groups

Limb length discrepancy (LLD) and deformities

LLD or inequality in the lengths of the lower limb is usually a source of concern for many parents. Fortunately most times these difference are so small that they are not apparent clinically and do not warrant any intervention. However, in a smaller group of patients there can be a significant difference in which case the source needs to be investigated and appropriate treatment instituted.

Some of the conditions that can cause LLD are:

  • Hemi hypertrophy - Idiopathic (no known cause) or secondary to increase blood flow to the limb.
  • Hip conditions - like neglected dislocation.
  • Arrest of the growth plate secondary to infections and injury to the growing areas of the lower limbs.
  • Foot condition - like clubfeet which causes the affected foot to be smaller leading to a shorter foot height and subsequently a shorter leg.

We have a dedicated team of sports surgeons, physicians, therapists and nutritionists at KK Women's and Children's Hospital (KKH) which allows us to treat sports injuries in children and adolescents in a coordinated and comprehensive fashion. This minimises adverse effects and maximises our patients’ rehabilitation and recovery.

 
 

 

 
     
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