Sporthopedia · Patient Information
Paediatric Orthopaedics
Children are not small adults. Their growing bones and joints need specialist care. Clear information for parents and young patients about the most common paediatric orthopaedic conditions.
Why Children Are Different
The Growing Skeleton
Growth Plates
Where Bones Grow
Growth plates close at the end of puberty (girls ~14–16, boys ~16–18). Fractures through growth plates are classified by the Salter-Harris system and may require specialist management to prevent growth disturbance.
Remodelling
Children Heal Differently
Children's bones have remarkable remodelling capacity — some fracture angulations that would be unacceptable in adults can correct themselves as the child grows, guiding treatment decisions.
Overuse Injuries
The Young Athlete
Rapid growth combined with intense sport training stresses growing bone-tendon junctions, leading to apophysitis (e.g., Osgood-Schlatter, Sever's disease). Early recognition prevents long-term damage.
Developmental
Some Conditions Are Developmental
Conditions like DDH (developmental dysplasia of the hip), clubfoot, and scoliosis may be present from birth or emerge during growth. Early detection and treatment leads to the best outcomes.
Common conditions
What Could Be Wrong?
Osgood-Schlatter Disease
Painful swelling just below the kneecap in active teenagers during a growth spurt. Caused by stress on the tibial tuberosity apophysis. Painful but self-limiting — almost always resolves when growth plates close. Activity modification and physiotherapy help.
Sever's Disease
Heel pain in 8–15 year olds during growth spurts — caused by stress on the calcaneal apophysis from the Achilles tendon. Very common in young footballers and gymnasts. Managed with heel cups, stretching, and activity modification.
Adolescent Idiopathic Scoliosis
Spinal curvature developing during the adolescent growth spurt — more common in girls. Mild curves are monitored; curves >25° during growth may require bracing; curves >45–50° may need surgery. Early school screening is important.
DDH (Hip Dysplasia)
Abnormal development of the hip socket, ranging from mild dysplasia to complete dislocation. Screened at birth with hip ultrasound. Early Pavlik harness treatment (under 6 months) has excellent results. Untreated DDH leads to early arthritis.
Paediatric ACL Tears
ACL tears in children with open growth plates require careful management. Growth-plate-sparing reconstruction techniques prevent growth disturbance while allowing return to sport. Increasing in frequency with youth sport participation.
Perthes Disease
Avascular necrosis of the femoral head in children aged 4–10, more common in boys. The femoral head loses blood supply, flattens, and then regenerates over 2–4 years. Treatment aims to keep the hip contained during healing — bracing or surgery depending on severity.
Treatment
What Happens Next?
Age-Specific Assessment
Children require assessment by surgeons experienced in paediatric orthopaedics. Growth stage (skeletal age), Risser grade (for scoliosis), and Tanner stage are all considered in making treatment decisions.
Non-Surgical First
Most paediatric orthopaedic conditions are managed non-surgically with bracing, physiotherapy, casting, or watchful waiting. Children's remarkable healing capacity often means less intervention is needed compared to adults.
Growth-Sparing Surgery When Needed
When surgery is required, paediatric techniques are specifically designed to avoid damaging growth plates. This includes physeal-sparing ACL reconstruction, flexible nailing for fractures, and guided growth for limb length discrepancies.
Long-Term Follow-Up
Many paediatric conditions require monitoring until skeletal maturity. Regular follow-up ensures that growth is proceeding normally, deformities are not worsening, and interventions are timed correctly.
FAQ
Your Questions, Answered
A limp in a child always warrants medical assessment. The cause may be minor (growing pains, Sever's, Osgood-Schlatter) or more serious (Perthes disease, septic arthritis, tumour). Do not ignore a limp that persists more than a few days or is accompanied by fever, night pain, or weight loss.
When necessary, surgery can be performed safely around growth plates using specialized techniques. Paediatric orthopaedic surgeons are specifically trained to avoid and minimize growth plate injury. The risk of growth disturbance is discussed with families before any procedure.
Knee pain in active teenagers is very common. The most common causes are Osgood-Schlatter (tibial tuberosity pain), patellofemoral syndrome (anterior knee pain), and osteochondritis dissecans (loose fragment of cartilage/bone). Most resolve with physiotherapy and load management — but an accurate diagnosis is important.
In babies under 6 months, DDH is treated with a Pavlik harness — a soft brace that holds the hips in a position that encourages normal socket development. Success rates are excellent when started early. Older children may need closed or open reduction and casting. Early newborn screening is key to catching DDH before it causes problems.
Questions about your child's orthopaedic health?
Connect with a Sporthopedia participating surgeon who specialises in paediatric orthopaedics, or learn about our research studies.
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