Posts Tagged ‘children scoliosis’

How to Avoid Backpack Injuries

Backpack AwarenessNobody ever said that being a parent is an easy job. You have to keep an eye on everything. Are they eating enough vegetables? Getting enough exercise? Spending too much time on their computer? With all the things you need to monitor in a day to keep your kids healthy and safe, it would be easy to overlook this one: Are their backpacks too heavy?

But the truth is, it’s something we should be thinking about each morning as we send them off to school, since backpack injuries are common in school-aged children. In fact, one in four students admit to having back pain for 15 days or more during the school year.

Dangers of an Overloaded Backpack

Heavy backpacks and book bags can lead to back, neck or shoulder pain and injury as well as long-term muscle, skeletal and nerve damage, including:

• Muscle spasms
• Scoliosis
• Spine injury
• Strain leading to headaches

ScienceDaily likens it to firefighters and soldiers carrying heavy occupational gear and notes this everyday reality for school children as a serious concern with serious potential risks. Backpack injuries have become such a widespread problem that some states have even passed legislation to “lighten the load.” With the average textbook weighing 3 ½ pounds, most schools are trying to find ways to address it, like switching to electronic text books and encouraging kids to leave unneeded items at school. The American Occupational Therapy Association (AOTA) has even headed up National School Backpack Awareness Day to teach safety tips to avoid injury.

Backpack Safety Tips

Thousands of children are treated each year for backpack-related injuries. How can you make sure your child isn’t one of them? We’ve got some tips.

Keep an Eye on Weight

A loaded backpack should never weigh more than 10 percent of your child’s body weight. That means if your child weighs 100 pounds, their backpack shouldn’t weigh more than 10 pounds. If your child is struggling to get the backpack on or off, has red marks on their shoulders from the straps, has to lean forward to carry the pack, or complains of back pain or tingling arms and fingers, it’s probably too heavy.

Choose the Right Size

A first-grader needs a smaller bag than a teenager, that’s why they come in age-appropriate sizes. You should look for the smallest backpack that can fit your child’s needs. The bigger the backpack, the more likely they are to keep stuffing things in. You might also consider a cross-body bag as an alternative.

Look for Added Comfort Features

Your best bet is to find a lightweight bag with wide, well-padded adjustable shoulder straps, a padded back and a waist strap. Multiple compartments can also help arrange items so they don’t shift around as much.

Pack the Bag Properly

Load the heaviest items first, so they rest closest to your child’s back. Arrange books and materials so they don’t slide around. Pack only what your child absolutely needs. If necessary, have your child carry a book or two by hand to avoid breaking the 10 percent weight rule.

Carry the Bag Correctly

To ensure weight is distributed evenly, backpacks should always be worn on both shoulders, with the waist belt buckled. Adjust the shoulder and waist straps so that the pack fits snugly. The backpack should rest evenly in the middle of the back and should never be more than four inches below the waistline (if it’s resting on their bottom, it’s too low).

Emory Orthopaedics & Spine Center

Emory Orthopaedics & Spine Center treats all types of shoulder, neck and back injuries. Schedule an appointment to see an Emory specialists today.

or call 404-778-3350


Take-aways from our Pediatric Orthopaedic Hip and Spine Chat with Dr. Fletcher

On February 5, 2013, Dr. Nicholas Fletcher, Emory Pediatric Orthopaedic Surgeon held a  live web chat to answer questions pertaining to the newest treatment options for pediatric orthopedic hip and spine conditions such as scoliosis, kyphosis, hip dysplasia, leg length differences and femoroacetabular impingement.

One of the most common pediatric orthopedic problems is hip dysplasia. Hip dysplasia occurs when the hip socket does not form correctly, which can lead to hip dislocation as a child grows, stated Dr. Fletcher in the chat. Unfortunately, hip dysplasia cannot be diagnosed in a child before birth, a great question which was asked by one of the chat participants. While hip dysplasia is not particularly common, mild abnormalities of the hip socket are regularly seen at birth, but parents should not be alarmed, as these abnormalities typically get better within a couple of months of a child’s life. One of the pediatric hip dysplasia treatment options Dr. Fletcher mentioned in the chat is called the Ganz Osteotomy, a procedure available at Emory. The procedure is used to realign the hip and settings of hip dysplasia when it is found in teenagers and adults.

Participants were also interested to learn that Emory is one of only a few centers in the southeast that offer hip preservation surgeries. Hip preservation is a surgical approach to hip problems in teens and young adults designed to prevent the need for hip replacement down the road. It usually involves realigning an abnormal hip socket into a more normal position or removing bone spurs in the hip that could lead to early arthritis.

Dr. Fletcher provided some great insights and answered some hard pressing questions from chat participants. If you would like to know more about the causes and treatment options of Pediatric Orthopaedic Hip and Spine conditions be sure to take a look at the live web chat transcript. Also, for more information on Scoliosis and on how to become a patient visit Emory Orthopedic and Spine online today.

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Get the Facts about the Orthopaedic Considerations for Children with Cerebral Palsy

Cerebral palsy (CP) is the most common motor disability during childhood. It is a life-long condition that affects the communication between the brain and the muscles and the condition can cause a variety of motor disabilities and issues. Disability resulting from cerebral palsy can be very mild, with the child appearing to be a little clumsy, to more severe, where the child may be unable to walk. Despite the difficulty with motor control/movement, many children with cerebral palsy have normal intelligence.

Common Symptoms of Cerebral Palsy include:

The signs and symptoms of cerebral palsy vary depending on the type of cerebral palsy, degree of disability, and how each child experiences these symptoms.

• Muscle weakness
• Difficulty controlling the arms or legs
• Shaking of the arms or legs (called spasticity)
• Muscle stiffness in the legs
• Clenched fists

Causes of Cerebral Palsy 
The cause of cerebral palsy is often unknown, but there are some links to premature birth, severe jaundice after birth, and an injury to the brain. If you have any concerns about your child’s development, talk to your pediatrician at your routine visit.

Unfortunately there is no cure for cerebral palsy right now. The best course of action is to manage the symptoms with a team of specialists including an orthopedic surgeon. At Emory Orthopaedics and Spine Center, when it comes to pediatric patients coping with cerebral palsy, we focus on preventing or minimizing deformities.

Orthopaedic Considerations & Risks From Cerebral Palsy:

Limb Shortening 
As a child develops, some children will develop a shortening of the leg and arm on only one side of the body. The difference between the legs can be up to two inches. If the parent notices a shortening, please contact a pediatric orthopedic surgeon who will be able to help determine the degree of difference between the legs and recommend appropriate treatment options. The surgeon may recommend a heel lift that is to be worn in the child’s shoes. A heel lift may also help prevent problems in the hip and spine. A leg length difference left untreated could eventually lead to a curvature of the spine called scoliosis.

Scoliosis is a curvature of the spine and is very common in children with cerebral palsy. One in five children with CP will have scoliosis so it is very important to see a pediatric orthopaedic surgeon to help monitor it. Scoliosis is usually mild and will not need anything more than regular observation by your doctor. Occasionally scoliosis can worsen and require more extensive treatments.

At the Emory Orthopaedics and Spine Center, we typically use non-operative treatments such as modification of a wheelchair, bracing or casting to minimize the worsening of scoliosis before we consider surgical treatments. Surgery is typically reserved for more severe cases of scoliosis. Emory pediatric orthopaedists Dr. Robert Bruce, Jr. and Dr. Nicholas Fletcher have extensive experience with growing rod and Vertical Expandable Prosthetic Titanium Rib (VEPTR) for the management of severe scoliosis in young patients. These techniques allow for continued growth of the spine in younger children to allow normal development and function. Some older children may need true spinal fusion surgery in order to stop the spine from curving.

Joint Problems
In children with cerebral palsy, it is often difficult to prevent “contracture,” an extreme stiffening of the joints caused by the unequal pull of one muscle over the other. The child will usually work with his or her care team to learn how to stretch the muscles to try to help prevent the joints from stiffening. The orthopaedic surgeon may also recommend braces, casting, or medication to improve mobility in the child’s muscles and joints. Occasionally contractures may begin to cause significant problems in the joints such as an inability to straighten out the leg and stand or a hip which may slide out of the socket. These are problems best managed by a surgeon with lengthening of tendons or perhaps a joint realignment surgery.

Foot Problems
Children with cerebral palsy will often also have difficulties with their feet due to the unequal pull of one muscle over another. These can result in problems with things as basic as getting a shoe on to walking or running. Most patients can be managed with physical therapy or possibly a special brace to hold the foot in a better position. Problems that are more severe may require surgery to rebalance the muscles in the foot or realign the foot so that it functions better.

If you have additional questions about Cerebral Palsy and its implications for pediatric patients, please leave them for us in the comments below.

About the Authors

About Robert Bruce, Jr., MD
Dr. Bruce has been a fixture in the Atlanta community for 17 years having started practicing at Emory in 1995. He is the director of the Children’s Healthcare of Atlanta (CHOA) cerebral palsy program and has a tremendous experience caring for all types of orthopaedic conditions in children with cerebral palsy from the spine to the hips to the feet. Dr. Bruce is also specialty trained in Ilizarov and the treatment of leg length differences and angular deformities. Outside of his clinical duties, Dr. Bruce serves on the CHOA medical board, is the past medical director of Egleston campus, and is currently the head of the orthopaedic team at Egleston hospital.

About Nick Fletcher, MD
Dr. Fletcher has been practicing at Emory since 2010 and cares for all forms of pediatric spinal problems including adolescent scoliosis, neuromuscular scoliosis, congenital scoliosis, early onset scoliosis, kyphosis, and spondylolisthesis. 
He also has spoken locally, nationally, and internationally on his research in scoliosis. His work on adolescent scoliosis has been presented as far away as Japan and he has published multiple studies on early onset and adolescent scoliosis. He also received the 2010 T. Boone Pickens Award for Spinal research for his research in Adolescent Idiopathic Scoliosis. Dr. Fletcher is a current member of the Pediatric Orthopaedic Society of North America’s (POSNA) evidenced based medicine committee and the Children’s Healthcare of Atlanta spinal infection prevention taskforce. His current research on post operative care following spinal surgery will be presented at this year’s POSNA annual meeting in Toronto, Canada.

Dr. Fletcher also specializes in pediatric and young adult hip conditions including hip dysplasia, femoroacetabular impingement (FAI), perthes disease, avascular necrosis, and slipped capital femoral epiphysis. He is one of only a handful of surgeons in the southeast with expertise in the Ganz or periacetabular osteotomy (PAO) for hip dysplasia and the modified Dunn osteotomy for slipped capital femoral epiphysis. He takes care of children of all ages with hip conditions in addition to young adults with hip dysplasia and impingement. He also has extensive experience in hip reconstruction for children with cerebral palsy and hip conditions such as dysplasia, subluxation, or dislocation.