Friday, January 19, 2024

Lameness - Limping in children: causes and treatment



What is lameness?

Claudication is an unbalanced and abnormal way of walking (trying to avoid stepping on one foot to avoid pain).

the reasons:

It may be the result of a problem in any area of the lower extremity (hip, nerves, knee joint, ankle, tendons, muscles, or bone...) and the causes vary according to age.

- From one to three years:

The lameness is due to (a thorn in the leg, an injury at the level of the nail, or due to the pressure of the shoe because it is narrow) or a fracture or for more severe reasons such as arthritis (which may be serious as a result of bacterial infections in one of the joints or in the back vertebrae or neurological diseases. The case requires medical intervention fast). Or as a result of chronic or temporary inflammatory diseases.

From three to ten years:

The lameness can be, in addition to the reasons mentioned above, due to fractures and temporary inflammation of the hip joint (colds of the hip) or insufficient blood supply to the head of the femur (Primary osteochondritis of the hip) i.e. separation of part of the head of the femur through The weak area known as the growth cartilage area. And the child becomes unable to roast in addition to feeling pain.

- More than ten years:

In addition to the previous causes, epiphysiolysis in the cartilage of the femur

Symptoms of lameness:

Depending on the type of lameness, there is a slow and chronic type that gradually worsens. Therefore, parents should always check the way the child walks. In some cases, the leg gradually tends towards the inside or outside, and the knee also bends gradually. The child tends to withdraw and not play with his peers.

If the child is exposed to a high average temperature or strong pain that makes him wake up at night from sleep or the inability to move the joint, he must be taken urgently to the doctor because it is a condition that may hide some tumors or cancerous diseases in the blood or germs or a strong inflammation, so the diagnosis must be early .

Diagnosis:

The diagnosis is made by listening to the parents and identifying the child’s symptoms or the extent of hereditary problems (chronic inflammatory diseases or blood problems). Examination of the patient, the method of walking, the leg in which he limps, the level of parallelism in the flexors of the thigh, and the length of the leg (if there is a leg longer than one). This case must be followed up and monitored every 6 months. After the clinical examination, the skin and abdomen are examined. Among the causes of lameness is also appendicitis or testicular torsion.
And the case may require other analyzes (ultrasound and MRI...) to identify the extent of infections.

treatment:

It depends on the type of lameness, and for short legs, the treatment is surgical to lengthen the leg. And if it is a sudden temporary infection, it requires rest, which is not possible because the child cannot stop playing. In this case, the child can be given painkillers and anti-inflammatory drugs, and if the disease is bacterial, he is given antibacterials. If the condition does not improve, surgery is performed to remove the synovial membrane of the germ. If the causes are cancerous, medications are given that are appropriate to the nature of the disease.