Birth defects: Early intervention can help children
According to the World Health Organization (WHO), out of every 100 babies born in India annually, 6 to 7 have a birth defect.
There are many orthopaedic conditions affecting children that need surgical intervention to alter the life of a child thereby improving the growth and development. (Photo: Pixabay) By Dr Vikas Basa
There is a wide range of orthopaedic problems in children that can be treated. Early intervention leads to a better outcome and a disability-free child. Birth defects otherwise called congenital anomalies may arise as a result of genetic, infectious, nutritional or environmental factors, however, it is difficult to identify the exact cause. Although these defects can be detected before birth, the necessary treatment can be offered at birth.
According to the World Health Organization (WHO), out of every 100 babies born in India annually, 6 to 7 have a birth defect. This would translate to around 17 lakhs of birth defects annually in the country and accounts for 9.6%. Developmental disorders are common in early childhood affecting at least 10% of children. These, if not intervened timely, may lead to permanent disabilities. Early detection and management of deformities in children bring added value in preventing these conditions from progressing to their more severe and debilitating form and thereby improving their quality of life.
There are many orthopaedic conditions affecting children that need surgical intervention to alter the life of a child thereby improving the growth and development. Some of these conditions are:
It is a foot abnormality, in which the foot points downward and inward. The condition is present at birth and involves the foot and lower leg. Clubfoot occurs in 1-2 per 1000 live births in India. About 50 per cent of these are bilateral i.e. it affects both feet and 5 per cent are ‘complex’. These cases are more often associated with other congenital abnormalities, especially neural tube defects, arthrogryposis (a condition associated with joint stiffness), chromosomal disorder and urogenital abnormalities. The male to female ratio is 3:1.
Management consists of a serial corrective plaster regime starting as soon as possible. Minor surgery is performed at the back of the child’s foot followed by maintenance of correction by a special shoe with a bar. The aim is to achieve a pain-free, functional, plantigrade foot in the long term.
Developmental Dysplasia of the Hip (DDH)
This occurs when the hip joint fails to develop correctly. It is caused by abnormal formation of the hip joint during the early stages of fetal development. It is sometimes also called congenital hip dislocation. It is estimated that 1 in 6 newborns will have an element of hip instability and 2 to 3 in every 1,000 infants will require treatment. Early detection and treatment are vital for effective ways to treat and manage it.
Cerebral Palsy is caused by brain damage and it is presented by loss or impairment of motor function. Cerebral Palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. It can also impact fine motor skills, gross motor skills and oral motor functioning. The child will likely experience a delay in development and growth milestones.
About 2-3 children out of every 1,000 have Cerebral Palsy, studies in the United States have yielded rates as low as 2.3 per 1,000 children to as high as 3.6 per 1,000 children. There is currently no cure as such for, but treatments are available to help with the condition. Children with this condition are cared for by a team of healthcare professionals, who can work with the parents to come up with a care plan.
While paediatric orthopaedic surgery involving correction of orthopaedic conditions in children are highly effective, they can be expensive. This is mainly because the deformities are usually complex, requiring more than one surgery to ensure full correction. Also, the appliances used in the surgery are high end and quite expensive. Further, to ensure excellence in the outcome, every child needs to undergo rehabilitation in the form of physical therapy and/or orthotics which adds an extra burden on the parents when it comes to cost.
Parents seeking treatment for bone deformities of their children should consider a centre for bones and joints, which is ideally equipped with a systematic approach that includes screening of children with deformities, early detection of growth and developmental disorders, advanced technology, multidisciplinary teamwork, and skillful and qualified paediatric orthopaedic surgeons. This will ensure the best care and treatment options for the child.
(The writer is Consultant Paediatric Orthopaedic Surgeon, Kokilaben Dhirubhai Ambani Hospital, Mumbai)
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