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This book brings together the congenital, acquired and traumatic
conditions which may affect the child's cervical and thoraco-lumbar
spine. The immature spine poses considerable diagnostic dilemmas
and radiographs are often difficult to interpret. The aetiology of
deformity, its assessment, monitoring and treatment are
comprehensively described. Back pain in children receives special
attention. Care has been taken to identify symptoms and signs which
should raise our level of anxiety and those which are likely to
resolve. Where surgery is necessary the principles and risks are
defined.
Children's upper and lower limb orthopaedic disorders has been
written to give orthopaedic practitioners an easily accessible and
concise description of regional disease and conditions encountered
in the practice of pediatric orthopaedic surgery. The upper limb
chapters describe fetal development and how this may go wrong. As
always, function dominates our management plans although cosmetic
considerations must be borne in mind. Perinatal brachial plexus
injury is analyzed and a plea made for early recognition and
reconstruction of both plexus lesions and peripheral nerve
injuries. The lower limb chapters consider limb deficiency and
deformity and how best we should manage them. Those prominent
afflictions of the child's hip - dysplasia, Perthes' disease and
epiphyseal slipping - are fully discussed. Chapters on the common
conditions affecting the knee, foot and ankle complete the book.
This book starts appropriately in considering the principles which
should govern our care of the injured child and the background
factors which influence fracture epidemiology. Knowing how to
manage the multiply injured child and recognizing the one who has
been non-accidentally injured are essential skills in our
specialty. Injuries to the growth plate are not always easy to
recognize and manage but, if we fail to do so, the long-term
consequences may be serious. Succeeding chapters describe childhood
injuries and fractures regionally. Conservative fracture management
has not been forgotten amidst the plethora of newer methods of
surgical fixation.
In this book we discuss how children grow, how to measure this and
how to decide whether development falls within normal parameters.
It is important not to over-investigate, but, if necessary, which
tests and imaging should we choose? We consider how best to look
after our patients in hospital, out-patients departments and at
home. This leads us to consider problems with the norm, including
the more generalised bone and cartilage disorders, most now
genetically determined. The section concludes with chapters on
infection, arthritis and that most emotive of topics, the tumours
of childhood.
The newborn child's immature nervous system makes early diagnosis
of some neurological disorders difficult: it is often only the
passage of time which clarifies the severity and pattern. Careful
analysis of motor skills, vision, hearing and speech allows us to
assess milestones. Progress from head control to sitting, standing
and the maturation of gait should be orderly. Informed examination
and the chapter on gait analysis highlight this development.
Chapters in this book describe neural tube defects, the recognition
and management of cerebral palsy and, lest we forget,
poliomyelitis. The book is completed by considering the muscular
dystrophies and arthrogryposis.
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