Crawling, Walking and Hip Disorders

crawlingwalkinghipdisorderHIP DYSPLASIA IN BABIES
“Hip dysplasia occurs when the ligaments that normally hold the ball of the hip into the cup are abnormally loose or relaxed so the hip slips out of place. It’s harder to diagnose in babies because it causes no discomfort and there aren’t any outward signs,” says Dr. Carl Weinert. “Treatment includes applying a harness that holds the hip into position. The baby wears it for two months full time and two months part time. The ligaments get tighter and the hip stays in place. If we treat this in a newborn, the harness treatment works most of the time.”

DELAYED HIP TREATMENT
A pediatrician often may diagnose hip dysplasia in an infant and refer the baby for orthopaedic treatment, says Dr. Weinert. If it’s not found in infancy, older babies may require surgery and a body cast for four months, he says. “An untreated child with hip dysplasia,” says Dr. Weinert, “will walk independently, usually by 14 months. So, delayed walking won’t necessarily be the clue that the child has this.”

TREAT CLUBFOOT EARLY
“With clubfoot, the foot is turned downward and inward. It’s obviously visible when the baby is born so diagnosis is easy. The earlier the treatment is started, the more successful it is and the easier it is,” Dr. Weinert says. “We prefer to see newborns within a week. The typical treatment is the baby gets a cast on his leg from his toes to above the knee. Each time the cast is changed-about once per week for six to eight weeks-the foot is manipulated slightly each time. Eventually, the foot’s final position is as upward and outward as a normal foot will go. Sometimes a minor surgery to lengthen a tendon is done during the casting procedure. After the last cast is removed, the child wears special shoes attached to a bar. The success rate of that treatment is about 90 percent.”

WHAT IS ORTHOPAEDICS?
Orthopaedics is the field of medicine that diagnoses and treats conditions of the musculoskeletal system, including bones, joints, muscles, tendons and ligaments. In babies and children, orthopaedic specialists commonly treat bone fractures, birth defects that affect the development of bones and joints, and spinal deformities like scoliosis. Often, neurological diseases such as cerebral palsy cause bone or joint deformities that require orthopaedic treatment.

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Dr. Carl R. Weinert
Dr. Carl R. Weinert
CHOC Orthopaedic Surgeon

PHYSICIAN FOCUS: DR. CARL R. WEINERT

Dr. Weinert is the Director of the clubfoot and musculoskeletal tumor programs in the Orthopaedic Institute at CHOC Children’s. As a clinical professor of orthopaedic surgery at UC Irvine, Dr. Weinert has trained hundreds of orthopaedic and pediatric residents, medical students, nurses, physical therapists and pre-med college students. He completed his internship at Mercy Hospital in Pittsburgh and a fellowship in orthopaedic research at the University of Pittsburgh. His clinical and research interests include bone cysts and benign tumors, clubfoot and hip reconstruction.

Dr. Weinert’s philosophy of care: “When a child develops an orthopaedic problem, it can be just as scary for the parents as it is for the child. I treat the entire family with the greatest compassion and understanding.”

EDUCATION:
University of Pittsburgh School of Medicine, Pennsylvania

BOARD CERTIFICATIONS:
Orthopaedic Surgery

More about Dr. Weinert | More about Orthopaedic Institute at CHOC Children’s

This article was featured in the Orange County Register on February 4, 2014 and was written by Amy Bentley.

How to Prevent Common Play Injuries in Children

Childhood cplayground injuriesan be a wonderful time, but it can also be a dangerous period when children can get hurt from the normal activities associated with playing and just growing up.

Dr. Carl Weinert, a CHOC orthopaedic surgeon, treats many children who are hurt from falls off playground equipment. The most common playground and fall injuries are fractures to wrists and elbows, he says. In addition, falls from scooters, bikes and backyard trampolines are a big cause of injuries in children. Children also get injured in bounce houses, he noted.

Trampoline injuries are much more common when there are multiple children using the trampoline at once, Dr. Weinert says. As more kids climb on the trampoline,  the risk of injury increases.

“Trampolines are far more dangerous if there is more than one child on it at a time because the recoil of the trampoline from one of the kids landing can launch another child off of it,” says Dr. Weinert.

Injuries incurred in bounce houses are frequently found in the elbow, Dr. Weinert says.

If you fall and try to force the elbow to bend backward instead of forward, it breaks, no matter how soft the surface is,” he says. “The most common injuries we see that need surgery are fractured elbows.”

Ailments that are more preventable are wrist and forearm injuries from skateboards and skates, Dr. Weinert says.

“Children should wear wrist guards,” he advises. “They are readily available and relatively inexpensive. Knee guards and elbow guards really only protect against scrapes.”

Signs of a serious injury from a fall can include lacerations, lots of swelling, an obvious broken bone or a bone protruding through the skin. If a parent notices any of these signs or if the child can’t walk, it’s time to see the doctor or emergency department quickly,  says Dr. Weinert.

“These injuries can be emergencies and they need help as soon as possible to avoid infection and to get the best outcome,” he says. “The fracture starts to heal when the child hits the ground. The longer treatment is delayed, the harder treatment is and the more compromised the result.”

Orthopaedic specialists at CHOC can help. The CHOC Orthopaedic Institute specializes in the diagnosis and treatment of complex orthopaedic injuries, illnesses and disorders in children and adolescents.  To make an appointment, call 888-770-2462.

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