Vision
/// Paediatric Orthopaedics: A multi-faceted specialty
The word “orthopaedics” (from the Greek ortho paedos) was created by Nicolas Andry in 1741, who gave it the meaning: “The art of preventing and correcting bodily deformities in children". This branch of medicine was therefore naturally aimed at young patients.
Over time, orthopaedics has obviously devoted itself to all the osteoarticular deformities that could be encountered by humans, as two-legged animals.
Since the beginning of the century there have been paediatric reference centres in France (Enfants Malades), the United States (Shriners Hospital) and England.
Since the middle of the 20th century, hospitals that are essentially adapted to the paediatric population have also developed in Belgium.
With progress in medicine, technological advances, improved surgical techniques and better pain management for children, hospital stays in Paediatrics have become less strenuous and increasingly short.
Paediatric Orthopaedics
/// The centre and its specialities
One of the particularities of the centre is the management of neonatal orthopaedic pathology. Thanks to its very active maternity ward, with more than 4,000 deliveries per year, our CHIREC Group (Delta and Braine L'Alleud) is a centre of excellence that recruits a significant number of neonatal orthopaedic pathologies. (Congenital dislocation of the hip, club feet and other foot deformities, congenital malformations of the limbs, obstetric trauma, etc.). Our paediatricians and radiologists, who are on the front line in the detection of all these malformations, have worked together to develop this sector.
Moreover, collaboration with gynaecologists in the context of antenatal diagnosis has improved this management by organising antenatal consultations when a congenital malformation is discovered.
Paediatric orthopaedics in everyday life includes all static disorders of the lower limbs in children and adolescents (torsion disorders, genu valgum, flat feet, etc.), limping and gait anomalies in small children. These pathologies are frequent reasons for parents to consult and express concern. In most cases simple monitoring is sufficient. Some, however, require surgical treatment. The development of new techniques is currently making it possible to correct many of these conditions.
The management of spinal deviations,
(scoliosis, kyphosis, etc.) is also a significant part of our work. Treating these conditions often involves rehabilitation and manufacturing orthopaedic corsets.
We work together in the team with a specialised prosthetist and physiotherapist to ensure optimal treatment.
Paediatric traumatology accounts for a significant portion of paediatric emergencies (+/- 60%). The treatment of fractures in children has evolved considerably over the last twenty years. The appearance of new orthopaedic implants has led to a significant increase in the number of surgical indications with optimised management. However, conservative treatment remains the first option, especially in young children.
Paediatric rheumatology concerns the management of all rheumatic pathologies in children (juvenile idiopathic arthritis, systemic inflammatory diseases, recurrent hereditary fevers, etc.)
Neuro-orthopaedics
involves management of children with motor disabilities. It is still not very present in our institution, but as the orthopaedist, the neuro-paediatrician, the specialised physiotherapist and the orthopaedic technician are working together with us, this could be developed.
There is generally a multidisciplinary approach to this management in order to avoid too many consultations for these children, for whom the strenuousness of their pathology becomes a limiting factor.
Our speciality is also concerned with treating sports injuries. Indeed, the increase in sports over the last twenty years among young people has led to a series of overload pathologies linked to the practice of increasingly intensive sports. Surgery, for certain indications, is deemed necessary. Collaboration with the physiotherapists is fundamental to enable our young athletes to resume their activities. In addition, acute knee pathologies in young sportspeople (ACL injury, meniscal lesion, osteochondritis, etc.) has seen the development of new surgical techniques adapted to the young patient.
The management of congenital upper limb malformations in children is another aspect of our speciality. This is made possible thanks to the collaboration of a specialised hand surgeon.
Finally, polymalformative orthopaedic pathologies most often require a genetic consultation.