Paediatric Orthopaedic Services

Bow legged knee, otherwise known as bow legs, is a common childhood condition where the knees seem bent or curved outward at the knees. As a result, the knees do not touch when standing. It is largely normal in those below the age of 2 years. In such instances, the child is usually asymptomatic and the knees straighten naturally as the child grows without the need for treatment.

However, if the knees remain as they are by the age of 3 years, they need to be evaluated by a doctor. Left untreated, bow legs may cause difficulties in the child's later years.

Clubfoot is a condition where an infant’s foot or feet are turned inward, resembling a golf club. In severe cases the foot may face sideways or upward. Its cause is unknown but some postulate genetics and space constraint in the uterus being factors behind it occurring. The foot adapts to the space in the wrong alignment and subsequently muscle contractures and bony / joint deformities set in.

Some cases of clubfoot may be detected during prenatal ultrasound, but this is by and large diagnosed at birth. Approximately half the children with clubfoot experience this problem in both feet, and boys are twice as likely as girls to have it.

During infancy, clubfoot does not usually cause pain but if it is left untreated, the child will be unable to walk normally.

Developmental dysplasia of the hip (DDH), formerly known as congenital dislocation of the hip, is a condition where the hip joint is not properly formed in babies and young children.

DDH may occur in one or both hips, and is more common among girls than boys. It can lead to difficulty walking and joint damage if left untreated hence early diagnosis and treatment is recommended to prevent such complications.

Flat foot or flat feet is a condition where one or both feet have little to no arch. As a result, the pads of the feet press into the ground while standing, without a visible arch.

While all babies have flat feet at birth, arches usually form as they grow older and the ligaments and tendons in the feet and leg tighten. Some will grow to have high arches while others have medium or low arches, and some will continue to have flat feet into adulthood.

For most people, having flat feet is not a cause for concern and does not cause any pain. However, some develop symptoms and we recommend a visit with a paediatric orthopaedist should there be any concerns.

Limb length discrepancy or limb length inequality refers to a condition where one arm or one leg is shorter than the other. Differences in arm length are less likely to affect normal function compared to differences in leg length, which impacts day-to-day activities such as walking and playing sports.

The difference in leg length can vary widely, from less than an inch to several inches. Significant differences are more likely to affect a person’s posture while standing or walking. This can lead to problems in the hip, knee and ankle and cause an apparent scoliosis (abnormal curvature of the spine).

Slipped capital femoral epiphysis (SCFE) is a condition affecting the hip joint in pre-teenagers and teenagers who are still growing. In SCFE, the neck of the thigh bone (femur) slips out of position at the level of the growth plate, in relation to the head. The growth plate which is made up of cartilages, is a point of weakness. The resulting slippage affects the alignment of the bone, and hence the joint.

These can potentially lead to problems with the hip joint and have consequences on many aspects of the patient’s health and abilities.