Thursday, Dec 2 2021 | Time 03:37 Hrs(IST)
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Dr. Ratnav Ratan, Delhi offers comprehensive treatment to resolve crooked limbs and limping in children

Children can suffer from complications of bone infection which leads to growth arrest, improper growth, and development in children. Infection on account of certain organisms can lead to bone infection which further affects the long bones of the arms and legs in children. If these infections are not treated properly, the affected bones are permanently damaged.

Recently, Dr. Ratnav Ratan,Orthopaedic surgeon in Gurgaon , treated a young patient who was suffering from post-infective growth arrest causing right hip deformity- coxavara and magna and left proximal tibial growth arrest with varus recurvatum deformity (oblique plane).

Growth arrest refers to the damage to the growth plate due to infection, trauma, injury, fractures, and many other reasons. The growth plate or phsyis is located at both the ends of the long bones in children and adolescents. These growth plates are ‘open’ for the bones to grow with the gaps. Upon the completion of the growing phase i.e. sometime during adolescence the growth plates close and the bones do not grow further and development of bony bridges. In case of damage to the growth plates, the gaps close early leading to crooked development of bones that needed immediate correction.

Such children exhibit abnormal and painless gait patterns on account of limb length discrepancy. If there is hips dislocation then they will display limited abduction and internal rotation of hips. It is essential to diagnose their condition considering the symptoms referring to various other orthopedic conditions.

Dr. Ratnav Ratan, one of the leading orthopedistat Pratiksha Hospital in Gurgaon and New Delhi states, ‘Surgical correction of Coxa Vara not only relieves the patient from pain and inflammation associated with it but also improves the quality of life of the patient. There have been instances of many young children who can walk normally and pain-free after undergoing suitable corrections and rehabilitation.’

Further, he states that early detection and treatment go a long way in helping the child to overcome this debilitating condition. Results of X-rays, MRI, and CT scans are relied upon to determine the conditions of the femur, femoral head, epiphyseal plate, and the growth plate for deciding the corrective procedure which is surgery.

Dr. Ratnav Ratan, one of the leading pediatric orthopedist in New Delhi and Gurgaon offers a comprehensive treatment of limb deformities due to growth arrest conditions. He is an expert in treating orthopedic conditions in children and adolescents apart from treating sportspeople as well. He narrates a case of his patient who recovered after undergoing 2-phase surgical procedures extending over six months.

A 6 YO Yemeni male boy approached Dr. Ratnav for treatment. He was limping with a crooked left leg since the time he began to walk. During the first year of his growth, he developed some infection in his right hip and left knee leading to abnormal gait along with limping on both the sides

Dr. Ratnav examined him physically and diagnosed that the child with coxavara - deformity of the right hip with instability while the left tibia was deformed and short. The left leg showed proximal tibialphyseal growth arrest.

Dr. Ratnav recommended surgical correction to resolve this condition. The surgical correction was done in a phased-out manner involving two procedures. In the first procedure, the correction of the right hip deformity was done by giving a cut in the proximal femur and a cut was made in the Pelvic bone to improve the coverage of the femoral head. This stabilized the right hip. The boy had to wear a spica cast for a couple of weeks. The spica cast is placed over one or both legs including the waist. This cast is used to stabilize the area and provide additional comfort to the child during the healing process after a hip surgery.

In the second stage, Dr. Ratnav performed a procedure to correct the left tibial deformity was using an Ilizarov frame. Extensive preoperative planning was done to position the rings and hinges of the frame appropriately. Gradual distraction corrected the deformity and the leg became straight and long after the completion of the distraction phase.

After the consolidation of the new bone, the rings were removed and the child was mobilized in a plaster.

Six months after both the surgeries, the child has got straight legs especially the left one, and with both the hips stable. The child can walk and run without any limp too.  The boy and his family are satisfied with the outcome of this life-changing procedure.

Conservative and non-surgical methods of treatment have proved more or less futile or with dissatisfactory results. Some of which include immobilization through spica cast, skeletal pin traction with bed rest, and so on. Also, it has been proven that untreated limb deformity leads to pain, progressive deformity coupled with degenerative changes especially loss of hip function.

Dr. Ratnav Ratan suggests that surgical interventions have proven to resolve the limb deformities and discrepancies with better outcomes. The treatment recommended is based on multiple factors such as type of growth arrest, size, type, location, and anticipated growth and deformity. It is essential to take into account patient goals and activity levels possible after the completion of the treatment.

The preferred treatment approaches could include single or multiple corrective procedures such as limb lengthening, deformity correction with the frame, contralateral epiphysiodesis, completion epiphysiodesis, corrective osteotomy, and excision of the physeal bridge.

Hence, early and timely medical intervention is very much essential in resolving the limp discrepancy, limping, and impaired functioning of the hip so that the children can grow and enjoy their lives in a much better way.

 

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