When you select Iowa Orthopaedic Center, P.C., for your child's pediatric orthopaedic care, you can be assured that your child will receive the highest level of orthopaedic pediatric care.  IOC is proud to have on staff one of Iowa's few board certified pediatric orthopaedic surgeons.  The Pediatric Orthopaedic Service at Iowa Orthopaedic Center, P.C., provides comprehensive treatment for the full spectrum of pediatric orthopaedic care for children of all ages, covering various clinical and surgical conditions including; congenital diseases such as club foot, hip dysplasia, and limb deformities; congenital deformities of the upper and lower extremities, limb lengthening, Intoeing, scoliosis and torticollis, and all types of fractures, sprains, dislocations, and traumatic injuries.

There are tremendous physiological differences between children and adults which must be taken into consideration when treating pediatric injuries involving bones, muscles, and joints.  The bones of an adult are no longer growing and are stabilized to sustain orthopaedic procedures that involve the bones and muscles.  When caring for children it's important to consider future growth and the changes in the bones and muscles that will occur over time.  There are many variables

to take into account when considering pediatric care including the age of the child, development and maturity of bones, growth plates, and the rate of growth (some bones grow more quickly than others).  The bones of an adult are quite hard when compared to the bones of a child.  Fractures in adults are usually well defined, because the bones are well developed and hardened.  When adult fractures occur, the bones typically "snap".  With children and adolescents, when their bones sustain fracture or injury, since the bones are not fully developed and matured, the bones often break in an incomplete manner (greenstick fracture) similar to breaking an early green branch from a tree.  Many times fracture sites in children are splintered, or not completely separated. 

When providing orthopaedic care to children it is important to consider the natural growth and development that will take place over the next several years.  You can be assured when selecting IOC for your child's pediatric orthopaedic care and treatment, we will provide the highest quality medical care, diagnostic service, with compassion to your child and address and answer any questions or concerns that you, as a parent, may have.   

Pediatric Fractures, Sprains, and Dislocations
IOC provides treatment for all type of pediatric fractures including, acute, simple and complex open and closed fractures, as well as, nonunions and malunions.  When children or young adolescents fracture a bone, the potential exists for growth problems depending upon the severity and location of the fracture site.  Many times it’s necessary for a cast to be applied to make sure that the fracture heals in correct anatomical alignment.  IOC provides experienced casting technicians to assure our patients are getting the best possible care.  Our casting technicians are highly skilled and put our patients at ease.  Young children often get to select the color of cast they want applied from a wide array of colors.  When possible, light weight casting materials are used for maximum comfort and healing.  Lighter weight casting materials, when appropriate, are especially good for young children with small extremities.

Unfortunately, for some fractures, surgery is necessary.  The skilled surgeons at Iowa Orthopaedic Center, reduce the fracture and perform the surgery necessary to place the broken bone(s) back into correct anatomical alignment until they are healed.  Casting is done following surgery and follow-up appointments are made to continue to check the healing of the fracture site.

Appropriate orthopaedic treatment for pediatric fractures, sprains, and dislocations provides your child with the best opportunity to return to normal childhood and adolescent function and activities.

Clubfoot
Clubfoot is found in newborns and is often associated with other congenital malformations, however, it can occur independently.  It is uncertain why some children are born with clubfoot deformity.  When treated properly clubfoot can be successfully treated and resolve in the stages of early childhood.  If left untreated, the clubfoot deformity can lead to painful and chronic complications.   

Treatment for clubfoot begins immediately after birth.  The foot of the affected extremity is manipulated, using the Ponseti Method, and placed in a cast.  Serial casting takes place weekly to gradually correct the deformity.   Alignment and positioning of the cast are critical to appropriately stretch and rotate the deformed foot into proper anatomical alignment.   When the Ponseti Method with serial casting does not correct the clubfoot deformity, surgery may be necessary.  Surgical correction consists of the orthopaedic surgeon releasing, or loosening the tight Achilles tendon to place the foot in its normal position.  Subsequent to surgery, most children wear a brace at night until the age of two.

Hip Dysplaisa (Pediatric)
Hip dysplasia, also referred to as hip dislocation, is categorized as either congenital, meaning it’s present at birth, or developmental, which refers to cases with a gradual development.  Hip dysplaisa, if not present at birth, usually presents within the first year of life. 

Commonly hip dysplasia is present at birth.  Hip Dysplasia is a comprehensive term that is inclusive of a broad spectrum of related developmental hip problems in infants and children. 

A basic description is below, breaking hip dysplasia into four main categories:

• Congenital Hip Dislocation - the hip is dislocated, but reducible;
• Congenital Dislocatable Hip - the hip presents in place, but completely dislocates when placed in stress;
• Congenital Subluxatable Hip - the hip is in place, but subluxatable (partially dislocates when placed in stress);
• Acetabular Dysplasia - the hip socket is shallow and stays shallow, causing the hip to be unstable.

In some children hip dysplasia may resolve spontaneously.   If the condition is left untreated it places the child at risk to develop serious conditions, including leg length inadequacy, gait problems, and even arthritis and chronic hip pain. 

Depending on the severity, surgery might be necessary to achieve returning the hip joint to its normal alignment and attempt to prevent any long-term disease and conditions such as osteoarthritis and chronic hip pain.  In cases requiring surgical correction, early intervention is critical for the best overall outcome of the child in future years.

Limb Lengthening & Deformities
As children grow, they may develop imbalances between their legs which can result in an uneven gait.  In extreme cases, this imbalance may cause difficulty as the child walks or runs. There is a corrective surgery called the Ilizarov procedure.  This procedure, in combination with other techniques for limb lengthening, can gradually correct the deformity to improve the alignment and length of the limb.

Intoeing
It is not uncommon for young children's toes to turn inward, a condition known as intoeing.  In the absence of other conditions or deformities of the foot such as clubfoot, this condition will usually correct itself without medical treatment or intervention. 

Commonly intoeing is caused in infants secondary to a turning inward of the front part of the foot. This is called metatarsus adductus and is caused by the position of the baby before birth.  Although the foot turns inward, the foot can be easily be moved into a normal position. This condition usually corrects itself as the child grows.

Tibial torsion (where the shin bone or tibia turns inward), is usually noticed once your child is walking. This condition usually corrects itself as well without medical treatment.  Medial femoral torsion (where the thigh bone or femur turns inward), is seen more commonly in older children, many times by a posture change it can be corrected. 

It's important that the physician treating your child understands the management of pediatric injuries and conditions at the various ages and stages of development.  Iowa Orthopaedic Center, P.C., is here to provide orthopaedic treatment and management for all of your pediatric conditions and injuries.   IOC delivers the highest standard of medical care, with the focus being on the patient and their needs.  We realize that when your child is in pain or injured, you are concerned and want your questions answered immediately and thoroughly.  For unparalleled medical care and service call 515.247.8400, or toll-free, 800.642.6381, and come see the experts at Iowa Orthopaedic Center, P.C.