Paediatric Orthopaedics

Burden of disease

Clubfoot is a congenital foot deformity occurs in 1 in 735 births and boys are affected twice as often as girls.

The Hip can dislocate at birth or soon after in 1 in 750 children. If left untreated the joint will become arthritic with children needing a hip joint replacement when they become teenagers.

The ball of the hip joint can lose its blood supply causing the ball to deform (Perthes’ Disease) in 1 in 8,000 young people.

Children can suffer from many diseases which make them unable to control their movement (Neuromuscular Disorders). Duchenne Muscular Dystrophy which is the most common inherited muscle disease affects 1 in 3,500 boys.

Cerebral Palsy is the most prevalent physical disability starting in childhood. It affects 150,000 individuals in the UK, including about 2,000 babies per year at birth.

Juvenile Rheumatoid Arthritis is the most common form of arthritis in children, affecting 10,000 to 20,000 children under 16 years of age in the UK.

Accidents and deliberate harm is the leading cause of death after the first year of life, exceeding all other causes of death in children combined. Every year 25% of children have an injury severe enough to require medical attention, absence from school, and/or bed rest.

Directions for future research

Improve screening techniques, particularly the use of ultrasound in the early detection of congenital dislocation of the hip.

The possibility of replacing the defective genes and prevent disease in children needs to be investigated.

The bones of a growing child needs any metal rod put in to correct a deformity to lengthen as the child grows. This needs further development.
Research molecular biological and genetic causes of limb growth disorders and identify defective genes.

Develop more physiologic treatments for the correction of deformities of bones and neuromuscular conditions including cerebral palsy and muscular dystrophies.

Improve childhood injury programmes.

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