Paediatric Orthopaedics

Istituto Ortopedico Galeazzi

key figures 

CLINICAL SERVICES:

  • Correction of Congenital and Acquired Deformities
  • Post-Traumatic Deformities Correction
  • Limbs Lengthening
  • Paediatric Fractures and Complications
  • Knee Arthroscopy Surgery  
  • Septic and Aseptic Arthritis Treatment
  • Cartilage Diseases

The Paediatric Orthopaedic Surgery Unit’s main field of interests concerns the treatment of paediatric orthopaedic and traumatological diseases and developmental age diseases. In particular, congenital deformity of the foot (flatfoot, clubfoot, pes equinus), hip (Perthes disease, DDH) and knee (Varus/valgus knee, Blount disease), cerebral palsy of the child, osteodysplasia, benign bone tumours, dysmetria of the limbs, osteochondritis, slipped capital femoral epiphysis, childhood traumas and the traumatic pathology of the knee in paediatric and developmental age patients, sport traumatology, obstetric paralysis, congenital stiff neck. Diagnosis, classification and conservative and surgical treatment of congenital and acquired deformities are offered at the Unit as well as correction of statutory defects and low disharmonic stature.

 

treatmentS

Foot Surgery 

The main pathologies the Unit deals with are surgical corrections of foot deformities (flatfoot, clubfoot, neurological foot). With regard to the flatfoot, the Unit implants endorthesis screws with possible accessory surgical steps (lengthening of the Achilles tendon and plastic of the posterior tibial tendon); for the clubfoot and neurological foot the Unit performs different types of corrective osteotomies, release of the soft tissues and tendon elongations. In the Unit, a multidisciplinary model is applied: thanks to the efficacy of the post-operative antalgic therapy set up in collaboration with the Anaesthesia team and the prompt execution of a post-operative radiography, the patient is discharged from the hospital in a short time, pleasing both, the patient and the caregivers. With regard to flatfoot the Unit performs on one foot at a time, so as to allow the little patient a swift return to sports activity.

Main Pathologies Treated:

  • Valgus flatfoot correction (subastragalics arthrorisis with endorthesis)
  • Correction of the clubfoot
  • Correction of the neurological foot

Knee Surgery

The Unit treats congenital varus/valgus knee deformities with hemiepiphysiodesis, using a plate (PediPlate) on the medial/lateral side of proximal tibia/distal femur to correct the growth of the physis. With regard to meniscal injuries the Unit performs arthroscopic selective meniscectomy as an outpatient surgery procedure, so the patient is discharged from the hospital after a short period of clinical and nursing observation. Patellofemoral instability is mainly treated with release of lateral alar ligament and/or plastic of vastus medialis muscle. Finally, the Unit deals with osteochondrosis and osteochondritis both with conservative and surgical approach.

Main Pathologies Treated:

  • Valgus knee and varus knee correction (hemiepiphysiodesis)
  • Surgical arthroscopy for the treatment of meniscal injuries and ligament injuries
  • Treatment of dislocation and patellofemoral instability
  • Treatment of dissecans osteochondritis
  • Conservative treatment of osteochondrosis

Hip Surgery

The Unit manages congenital hip dysplasia with a conservative approach following the patient in the peri and postnatal period, in a close cooperation with orthopaedic technicians and radiologists.

Main Pathologies Treated:

  • Conservative treatment of congenital hip dysplasia

Lower Limbs Surgery

The Unit treats congenital heterometry (e.g ectromelia) and acquired heterometry (post-traumatic) with simple and complex axial deviations; the management of these cases consists of correction with circular external fixation and hexapod apparatus. The Unit pays particular attention to achondroplasia and a multidisciplinary model is applied with a team made up of surgeons, physiotherapists, and psychologists (dedicated to supporting the family and the patient during their journey). With regard to the surgical procedure, the Unit performs lengthening of the lower limbs with external fixator in multiple steps, starting first with lengthening of the tibia bilaterally, then the femur bilaterally.

Main Pathologies Treated:

  • Treatment of congenital and acquired heterometry, of simple and complex axial deviations, by means of elongation with axial, circular external fixation and hexapod apparatus

Vertebral Column Surgery

The Unit is also specialized in the management of vertebral column deformities and osteochondrosis (Sheuermann disease) with a conservative approach e.g corsets and physio kinesitherapy.

Main Pathologies Treated:

  • Conservative treatment of the deformities of the vertebral column
  • Conservative treatment of vertebral osteochondrosis

Traumatology Surgery

The Unit takes charge of paediatric fractures (upper and lower limbs) and treats them with reduction and stabilization through internal and external fixation, depending on the case. The Unit also manages paediatric fracture's complications like non-union, axial deviation, infection and treats them with external fixation (circular external fixator, hexapod apparatus), also with Ilizarov technique.  

Main Pathologies Treated:

  • Paediatric Fractures, Salter-Harris fractures
  • Stabilization of fractures with internal and external fixation    
  • Management of fractures complications (non-union, axial deviation, infection) with axial, circular external fixation and hexapodal apparatus with Ilizarov technique                                                                                                                                                                                                                                                                                        

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

  • Circular and hexapod external fixation  
  • EOS X-ray technology