Orthopedic Surgery
The Pediatric Orthopedic Service at the Perinatal Center plays a crucial role in the diagnosis and management of musculoskeletal conditions that can affect newborns. Our team consists of four board-certified, fellowship-trained pediatric orthopedists who comprise the faculty of Weill Cornell Medical College and the world-renowned Hospital for Special Surgery (HSS), recently ranked the number one provider of orthopedic care in the country by US News and World Report.
A variety of orthopedic conditions can affect children in the perinatal period. Prompt and skilled attention to these conditions allows for the most optimal outcomes. When problems are recognized in the prenatal period, parents can better prepare for the arrival of their child. Through research of available treatment options and consultation with an expert, parents comprehend the nature of their child's condition, which facilitates expeditious and appropriate treatment following delivery of their infant.
Prenatal consultations to educate and prepare parents for delivery of their child with a congenital musculoskeletal condition are provided by our pediatric orthopedists. Some conditions that may be diagnosed prenatally at around 20 weeks include clubfoot, congenital short femur, skeletal dysplasias, and congenital spine anomalies.
Common orthopedic conditions seen in newborns
Hip Dislocation and Hip Dysplasia
A hip dislocation occurs when the ball of the hip joint is not in contact with the socket. This may be diagnosed when a baby is examined shortly after birth. There are several variants of this condition, including hip dysplasia, when the socket is shallow, and hip instability, when the hip slides in and out of place. Ultrasounds are frequently used to assist in the diagnosis of these conditions. When diagnosed shortly after birth, hip dislocations can usually be treated with a painless brace that restores the hip to normal without the need for invasive procedures, such as surgery.
Clubfoot
Clubfoot is a deformity in which the foot is turned inward and downward. It is frequently diagnosed prenatally, allowing parents time to learn about the condition and research treatment options. The pediatric orthopedists at the NewYork-Presbyterian Hospital's Perinatal Center and HSS use the Ponseti Technique for management of all clubfeet. This is a method in which the feet are gently manipulated and casted on a weekly basis to straighten them. A strict bracing protocol follows the casting period. This technique is the most successful method of clubfoot management but requires specialized training and commitment to properly administer it.
Other Foot Deformities
Metatarsus adductus and calcaneovalgus are two other very common foot deformities in newborns. Metatarsus adductus is a bending inward of the foot and calcaneovalgus is a bending upward. Both occur as a result of positioning within the uterus and typically resolve with simple stretching.
Fractures
Occasionally children sustain fractures (broken bones) around the time of delivery or shortly after. The most common of these are fractures of the clavicle, humerus, and femur. Fortunately most of these injuries heal promptly without consequence. Expert orthopedic management minimizes discomfort and allows a prompt recovery.
Musculoskeletal Infections
Newborns with serious medical conditions can occasionally have compromised immune systems, placing them at risk for infections of the bones or joints. In these cases, multidisciplinary management is crucial for optimal outcomes. At the Perinatal Center, pediatric orthopedists work with perinatologists, pediatric infectious diseases specialists, pediatric radiologists and pediatric anethesiologists to diagnose and treat bone and joint infections using a combination of medical and surgical management.
Orthopaedic Conditions Often Diagnosed Prenatally
Congenital Short Femur
The femur, or thigh bone, connects the hip and the knee. A rare congenital abnormality can occur in which the femur does not develop normally. The spectrum of this disorder runs from mild shortening of the femur that may require only a simple lift in the shoe, to a partial absence of the bone in which limb lengthening procedures are necessary. Early diagnosis is helpful to prepare for treatment, although surgical management is usually not necessary until after the first year of life.
Skeletal Dysplasias
Skeletal dysplasias are a heterogeneous group of conditions in which the bones do not form or grow properly. Prenatal studies can raise the suspicion of a skeletal dysplasia; however, a definitive diagnosis is not typically made until after birth. Children with these conditions can be at risk to develop limb and spinal deformities that often require orthopedic management.
Spinal Deformities
Abnormalities in the formation of the spine can result in curvature and twisting of the spine to the side (congenital scoliosis) and bending forward of the spine (congenital kyphosis). Early diagnosis can allow the best outcomes by preventing deformities from becoming severe. Treatments implemented by pediatric orthopedists can include close radiographic screening with x-rays at regular intervals, bracing to prevent worsening of deformities and, occasionally, early surgery for severe and rapidly progressive deformities.
Our Pediatric Orthopedists
Shevaun Mackie Doyle, MD
Dr. Doyle practices general pediatric orthopedics.
Daniel W. Green, MD
Dr. Green practices general pediatric orthopedics, with a special interest in hip disorders and spinal deformities including scoliosis.
David M. Scher, MD
Dr. Scher practices general pediatric orthopedics, with a special interest in hip disorders, foot deformities, and cerebral palsy.
Roger F. Widmann, MD
Dr. Widmann practices general pediatric orthopedics, with a special interest in hip disorders, spinal deformities including scoliosis, and limb deformities.
Contact
- Pediatric Orthopedics
- Prenatal consultations with our Pediatric Orthopedists can be arranged by calling any of the individual office numbers, or the HSS Kids Hotline.
1-877-HSS-1KID (1-877-477-1543) - Telephone: (212) 746-3561