Orthopedist - what does he treat? When should you see a doctor? Pediatric and adult traumatologist-orthopedist. What does an orthopedic surgeon do? Visiting instructions. How to make an appointment? How to get advice

What is an orthopedist? He is a specialist, whom it is advisable to contact in cases where there are any diseases or defects related to the musculoskeletal system. As part of the consideration of what this doctor does, one can especially note developmental defects that are relevant for skeletal system, as well as congenital forms of pathologies and complications that develop as a result of the transfer infectious diseases. Among other things, this list includes domestic injuries along with various injuries and conditions within the post-traumatic period. So, let's find out in more detail: what kind of doctor is an orthopedist, and what diseases does he treat?

Main activities

So, the orthopedist deals with diseases related to the skeletal system. The specialization owned by one or another orthopedic doctor determines the specific directions of the features of his activity. Let's bring existing options these kinds of directions:

• Outpatient or, as it is called in another way, conservative orthopedics. In this situation, consider the implementation preventive measures regarding diseases of the musculoskeletal system in clinical setting where the orthopedist takes. In addition, this direction is concentrated within the framework of the implementation of non-surgical therapeutic measures for the impact on diseases of the joints and bones.
• Endoprosthesis technique. This direction focuses on the implementation of measures related to the surgical prosthetics of bones and joints, which is especially important in those situations in which it is no longer possible to save them using other methods of treatment.
• Surgical field of activity. What is an orthopedic surgeon? As part of this area of ​​orthopedics, the spine, feet, teeth and hands are treated. This direction is considered radical in treatment, as it affects the ligaments, joints and bones of a person.
• What diseases does an orthopedist treat in traumatology? Treatment methods are conservative and surgical therapy, which is focused on the impact on injuries that are somehow related to the skeletal system. This includes, in addition, the timely fixation of fractures, along with measures that are aimed at correcting joint defects. In the field of traumatology, they also deal with the correction of chronic forms of defects. Sports orthopedics are also included in this area. Its purpose lies in the treatment of specific injuries acquired by athletes in the course of their activities.
• Pediatric orthopedics, or, as it is also called, adolescent orthopedics. This direction of orthopedics focuses on the prevention and required treatment of defects that are relevant to the skeletal system. What kind of doctor is a pediatric orthopedist? This is a specialist to whom small children under the age of one year come for an appointment. Quite often, older guys along with teenagers become patients.

What does an orthopedist treat? Tasks of the doctor

Based on all of the above features that determine the specifics of the activities of an orthopedist in the role of a particular specialist, one should summarize and indicate what this doctor treats:

• Muscle diseases.
• Joint problems.
• Tendon stretch.
• Ligament damage.
• Bone injury.
• Nerve endings.

All this is done by an orthopedist. What organs does this doctor treat? With regard to this issue, it should be noted that this specialist deals with the back, feet, shoulder blades, knee and hip joints, humerus, teeth and so on.

Orthopedist and the pathologies he deals with

What diseases do orthopedic doctors treat? If we talk about specific ailments, then we should highlight following list their main types:

• The presence of curvature of the feet along with flat feet, clubfoot.
• Congenital diseases in the form of joint dysplasia and torticollis. Often the help of an orthopedic infant is needed. What doctor is this? More on that below.
• The presence of bursitis, arthrosis in patients, that is, diseases that are accompanied by inflammation of the periarticular bags and joints, including.
• The development of osteochondrosis, that is, a chronic disease, which is accompanied by damage to the spine in the region of its specific segments.
• Joint dislocations along with bone fractures and Ewing's tumor.
• Development rheumatoid arthritis, that is, a system-wide chronic disease, the features of the course of which suggest damage to the skeletal system, which in turn can lead to severe forms joint deformities. Such a pathology in some situations may be a prerequisite for subsequent disability in the patient.
• The presence of osteogenic sarcoma.
• The development of deforming osteosis along with chondromyxosarcoma.

When do you need to see an orthopedist?

It should be noted that some of the types of diseases that have been listed are only a small part of their existing options. Among other things, the variety of such discrepancies is noted not only in pathologies, but also in methods of treatment, which relates to injuries and diseases of the skeletal system.

Diseases of the joints, bones, ligaments, spine and tissues that are located in the immediate environment of the affected area may be congenital or acquired during life, and, in addition, may have an infectious nature of occurrence. Acquired pathologies are always associated with any injuries or occupational injuries along with metabolic disorders. Infectious diseases occur due to concomitant inflammation as a result of the transfer of a particular disease.

Erased symptoms

The development of various bone disorders occurs, as a rule, in a very slow manner, because the first symptomatology, which might require an orthopedic consultation, may be mild. But serious and bright pronounced manifestation symptoms will be noted at the stage of large-scale lesions that occur against the background of pathological processes. Given this feature, visiting the orthopedist's office should become regular, and this must be done from childhood.

Traumatologist-orthopedist - what kind of doctor is this? Let's take a closer look at this issue.

When is it necessary to contact an orthopedic traumatologist?

In this situation, as is already clear from the indicated direction of the doctor's specialization, we are talking about his connection with various injuries and the elimination of their consequences. In this regard, a number of reasons are determined, within the framework of which a visit to the office of an orthopedist-traumatologist is required:

• Fractures resulting in dysfunction of the bones.
• Re-transfer of fractures by the patient.
• Residual signs of human transmission of polio.
• Not stopping, but, in addition, persistent pain in the region of the spine, limbs and joints.
• The presence of sprains, bruises, frostbite, insect or animal bites.
• Deformation of the limbs or other injuries inflicted on the spine, chest.
• Damage to the functions of small and large joints.

Operative and closed intervention

As part of the ongoing treatment, an orthopedic traumatologist can apply methods of surgical and closed intervention. This technique is called redressing. In this situation, they imply a phased correction by an orthopedic doctor that is relevant for the patient. pathological disorders, and, in addition, deformations in the region individual joints, which relate to the system of support and movement. The doctor makes this correction with his hands. In particular, in this case we are talking about correcting contracture, clubfoot, as well as curvature of the limbs as a result of rickets, fibrous ankylosis, fractures that ended with improper fusion, and so on.

This is what an orthopedist treats and does. What doctor is this? This question can be heard from patients quite often.

When is an urgent visit to the orthopedist required?

Allocate a certain group of symptoms, on the basis of which it is required urgent appeal to the orthopedist, as such pathological condition can act as a kind of signal that will indicate the development of a serious pathogenic process, and, in fact, the disease itself. About such a need for medical care You should speak in case of the following manifestation of symptoms:

• The presence of a crunch in the joints.
• Poor joint mobility.
• Feeling of numbness in hands.
• The appearance of swelling of the joints.
• Soreness in the joints during any, even the most insignificant movements.
• Appearance pain in back.
• Violation of posture along with a quickly emerging feeling of fatigue.
• Availability aching pains and muscle aches, which are caused by changes in the weather.

Regular visit

There is, in addition, a number of diseases, the development of which determines the need for a particular patient in a regular visit to the orthopedist. Among them are the following types of diseases:

• Presence of rheumatoid arthritis.
• The transfer of the patient any injuries of the spine.
• The presence of arthrosis of the joints.
• Shoulder or knee dislocations.
• The development of osteochondrosis.

Moreover, orthopedic traumatologists can advise preventive actions with regular sports loads, and, in addition, when choosing extreme types of recreation as a way of spending time. In this case, it will be possible to timely eliminate certain injuries, which, in turn, will make it possible to eliminate the problems that accompany them in the future.

Dental orthopedist - what kind of doctor is this?

This specialist eliminates the most various violations in the mouth and maxillofacial region:

• Restores the integrity of individual teeth. Manufacture of microprostheses.
• Restores the integrity of the dentition.
• Produces prostheses that replace soft tissue defects of the maxillofacial region after injuries, including after surgical interventions.
• Treats diseases of the temporomandibular joint.
• Carries out the correction and repair of prostheses already existing in the patient.

This is what kind of doctor is an orthopedist in dentistry.

When should you take your child to a pediatric orthopedist?

There are a number various circumstances under which you should visit this specialist with your child. Thanks to timely handling you can get to the orthopedist effective results concerning the elimination developing pathologies. Plus, it becomes possible to correct congenital forms of any diseases associated with propulsion system, if any. So, such circumstances include the presence of the following defects:

• Defective position of the hip, which can be noted in a newborn baby. This usually happens with congenital dislocations.
• Rapid fatigue of children while walking. Noticeable visual heaviness of the gait. In this situation, we are usually talking about flat feet.
• A noticeable stoop along with a constant inclination of the head to the same shoulder. In this case, most likely, we have to talk about torticollis.
• Complaints of the child about the periodic appearance of pain in the arms and legs, and, in addition, in the neck or back.
• The presence of clubfoot, in which it visually seems that the child is raking with his foot during his walk.

How is the first appointment?

Very often, patients are interested in how the first appointment with an orthopedist takes place. In order to get an approximate idea of ​​​​this, we will tell you about the main nuances of visiting this specialist:

• The orthopedist visually evaluates anatomical structure relevant to the skeletal system. In this situation, the correctness is analyzed along with the irregularity of the structure. This stage is especially important when examining newborns.
• The specialist determines the range of motion that is relevant for the affected joints.
• The doctor prescribes fluoroscopy, within which, as a rule, the alleged diagnosis is clarified or refuted.
• The presence of complex forms of diseases may require the need for such research methods as CT scan along with magnetic resonance imaging.

We examined who this orthopedist is and what this specialist treats.

Book an appointment with an orthopedist

Who is an orthopedist, orthopedic traumatologist and orthopedic surgeon?

Various deformations of the musculoskeletal system may appear due to various reasons such as trauma, birth defects development, long-term inflammatory diseases etc. However, regardless of the cause of the deformity of the musculoskeletal system, an orthopedist is engaged in their correction.

Orthopedics is closely related to another medical field - traumatology, which deals with the diagnosis and treatment of various injuries of muscles, bones, joints and ligaments. However, traumatologists identify and treat "fresh", recent injuries of the musculoskeletal system, such as fractures, sprains, ruptures of muscles and tendons, etc. But orthopedists identify and treat deformities of bones, muscles and joints that occurred relatively long ago, and managed to heal and fix themselves in the wrong position.

Due to the close links between traumatology and orthopedics, these medical disciplines are combined into one specialty. This means that after graduating from the institute, a doctor who has completed an internship or residency in the specialty "orthopedics and traumatology" is qualified as a "traumatologist-orthopedist". After completing an internship or residency, a physician may work in the field of orthopedics or traumatology. It is impossible to complete an internship or residency in the specialty only orthopedics or only traumatology and, accordingly, qualify as an "orthopedist" or "traumatologist". These disciplines are one specialty, like "obstetrics and gynecology".

Accordingly, the term "orthopedist-traumatologist" is the correct and full name of the specialty of a doctor involved in the identification and treatment of injuries and deformities of the musculoskeletal system. But besides this, in the term "orthopedist-traumatologist" in everyday life, another meaning is also invested - that a doctor can simultaneously repair injuries as a traumatologist, and treat deformities of the musculoskeletal system as an orthopedist. The name is simple "orthopedist" is clarifying, since it contains the meaning of the fact that this doctor focuses specifically on the direction of orthopedics, and traumatology is in the background.

Based on such terminology features, if a person has any complex damage to bones, joints, muscles or ligaments, which will subsequently give a deformation of the musculoskeletal system, then he needs to contact an orthopedist-traumatologist, who can simultaneously eliminate the damage, and then carry out the correction of the resulting deformations. If a person has any deformity of bones, joints or muscles without acute injury, then to eliminate it, you should contact an orthopedist who is focused on this industry and is not distracted by traumatology.

Term "orthopedic surgeon" implies a specialist who can produce not only conservative, but surgery(operations) of various deformations of bones, joints, muscles and ligaments. In principle, traumatology and orthopedics is a surgical specialty, the possession of which implies the performance of operations. But in practice, not all orthopedic traumatologists perform surgical interventions, some doctors specialize only in conservative therapy. Therefore, when they say "orthopedic surgeon", they mean that the doctor treats deformities of bones, joints and muscles, not only conservative methods, but also with surgical operations. Accordingly, if a person has any deformity of bones, joints, muscles or ligaments that requires surgical treatment, then he should refer to the "orthopedic surgeon".

An orthopedic surgeon can apply both conservative and operational methods treatment of deformities of the musculoskeletal system. So, for example, contractures, clubfoot, congenital dislocation of the hip are treated with conservative methods using plaster bandages, scoliosis - with the help of corsets and a specially designed set of physical exercises, etc. But the curvature of the bones, paralysis, tendon ruptures are treated with surgical methods, performing operations to restore the normal position of the bones, tendon transplants, etc. Regardless of whether an operation or conservative treatment deformities of the joints, bones or muscles, orthopedic doctors widely use various orthopedic devices, such as shoe insoles, corsets, prostheses, splint sleeve devices.

It should be remembered that orthopedics is a very extensive medical field, as a result of which there are separate narrow areas in it: spinal surgery, intra-articular operations, joint prosthetics, etc. Accordingly, different orthopedic traumatologists can specialize in one or another area of ​​orthopedics or traumatology, and therefore not all doctors will undertake the treatment of any orthopedic or traumatological pathology.

Children's orthopedist

The selection of a pediatric orthopedist as a separate specialty was made because the doctor needs to know the features of bones, joints and muscles in babies different ages, as well as the rate of their growth, and take this into account when choosing therapy. Due to the peculiarities of the structure and growth of bones, joints and muscles inherent in children, pediatric orthopedists are a separate medical specialty.

What does an orthopedist treat?

• Congenital malformations of the limbs (for example, congenital dislocation of the hip), neck deformities, chest and spine;
• Clubfoot;
• Scoliosis and other posture disorders;
• Torticollis;
• Joint deformities after past injuries or due to chronic diseases(for example, deforming osteoarthritis, aseptic necrosis of the femoral head);
• Osteocondritis of the spine;
• Deformities of the arms or legs resulting from injuries or any past diseases;
• Arthrogryposis ( congenital disease characterized by deformities and underdevelopment of bones, joints and muscles);
• Cysts or benign bone tumors;

Operative methods of treatment are a combination various operations, which are produced in order to eliminate deformation and restore the normal position of bones, elements of joints, ligaments and muscles. Surgical treatment in orthopedics is carried out if the deformities of the musculoskeletal system cannot be corrected by conservative methods. During surgical treatment, strictures can be excised, muscles and ligaments can be sutured, and prostheses can be inserted.

In his work, to diagnose and monitor the effectiveness of treatment, the orthopedic surgeon uses only instrumental methods surveys, for example:

• CT and MRI (computed tomography and magnetic resonance imaging).

In what cases should you contact an orthopedist?

• Torticollis (neck tilt to the side and down with the inability to straighten the head);
• Any deformities in the joints (for example, crookedness, inability to bend or straighten the joint, etc.);
• Any bone deformities (for example, a skewed pelvis, curvature of the bones of the chest, legs, arms, etc.);
• Any violation of posture;
• flat feet;
• Clubfoot;
• Habitual dislocation of the hip or shoulder;
• Osteochondrosis;
• Residual effects after poliomyelitis;
• Difficulty, pain or limited movement in any joint;
• Persistent, persistent pain in the joints, arms, legs, or spine;
• The need for rehabilitation after injuries;
• The need for the selection of prostheses or orthoses.

Reception (consultation) of an orthopedist - how to prepare?

Since the orthopedist will necessarily perform a physical examination, the deformed area should be washed, bandages and other devices used to improve the condition on their own should be removed from it. You also need to dress in such a way that you do not feel shame or embarrassment in the process of undressing in front of the doctor.

In order for the orthopedist to be able to make a diagnosis and prescribe treatment literally in one visit, before consulting a doctor, you can take an x-ray or tomography of the deformed area of ​​the musculoskeletal system. In this case, you need to take pictures and conclusions of studies with you to the appointment.

In addition, it is imperative to take all available x-rays, tomograms, ultrasound records and other studies that were previously performed on the deformed area of ​​the musculoskeletal system (if any, of course, if any) to an orthopedic appointment.

Where does the orthopedist take?

General information

Orthopedist in the clinic

Orthopedist in a rehabilitation center

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In the first year of life, the child develops especially actively. Therefore, it is necessary constant control specialists. Problems identified early on big chance for a successful fix. 3 months - important age. At this time, doctors can draw the first conclusions about how the baby meets the standards, whether he has any hidden diseases.

If the question arises of which specialists you need to go through, then the first thing you need to do is go to the pediatrician. It is he who will issue referrals for visiting other doctors and prescribe tests.

Visits to the pediatrician should be monthly until the child is one year old. After discharge from the maternity hospital, the doctor himself comes to the house, and starting from 1 month, you need to go to the clinic on your own. At each examination, the height of the baby, its weight and head circumference are necessarily measured. They do this in order to see the development of the baby in dynamics. Comparison with other children and norm tables is not very revealing. But a head that has grown significantly in a month can mean hydrocephalus. To exclude or confirm the disease, the doctor will prescribe an additional examination, such as neurosonography. If the pediatrician notes insufficient weight gain in the crumbs, he will recommend that the mother reconsider the diet or introduce supplementary feeding. These measures will avoid serious consequences.

The doctor will also examine the throat and listen to the breath. Most likely, he will ask if the baby's colic is over. After all, by 3 months work gastrointestinal tract usually normalize. If not, then the specialist may consider it necessary to prescribe an analysis for dysbacteriosis.

In addition, at this age you need to pass general analysis blood and urine. Collecting material for research can be difficult. It is most convenient to do this using special urinals. They are sold in pharmacies and are for girls or boys, created taking into account their physiological characteristics.

If the result shows that the child is healthy, the doctor will refer him to DTP vaccination. It is at the age of 3 months, if there are no contraindications, that the first stage of vaccination against whooping cough, diphtheria and tetanus is carried out. Also, if the baby has not been vaccinated against hepatitis B before, now is the most right time do it. Of course, the mother has the right to refuse vaccination. But we must take into account all the risks associated with the child's lack of immunity to dangerous diseases.

And, of course, during the examination, you can ask the doctor all your questions related to the development of the baby and his health. After all, when it comes to babies, any little thing can matter.

What does a neurologist check?

Also at this age it is important to go through another specialist - a neurologist. He will also measure the circumference of the head, check the condition of the fontanelles. If the doctor has any concerns, for example, if the crown bulges and pulsates, then he will prescribe additional examinations. They are also needed if any abnormalities were previously detected on neurosonography. Only in dynamics will it be possible to draw a conclusion about the condition of the child.

For examinations, it is worth taking a diaper with you, on which you can put the baby. Since the trip to the clinic can be delayed, you need to worry about nutrition for the crumbs.

The neurologist checks the reflexes, how developed they are by this age. Some, such as automatic walking, should fade by 3 months. Also, the doctor will assess the condition of the muscles. In newborns, the muscles are constantly in good shape. Gradually they relax, the fists open. If this does not happen, then it may be necessary to undergo one or more courses of professional massage and therapeutic gymnastics. Timely activities will allow the baby to develop properly.

Visiting an orthopedist

At 3 months you need to visit an orthopedist. After all, the child is growing rapidly, and now pathologies that have not been identified before may appear. The doctor will check how symmetrical the folds are in the crumbs, assess whether the spine is formed correctly, how freely the legs are bred and how the feet are developed. This will allow early detection of dysplasia hip joints and predisposition to flat feet. Perhaps the suspicion of dysplasia arose earlier, during the last examination. Then the specialist could prescribe wide swaddling or other measures to correct the situation. Now he will see how effective they were and what actions are needed next.

On examination, the doctor may note the first signs of rickets. it serious illness associated with a lack of vitamin D. It affects the development of the bones and muscles of the child. The doctor must prescribe tests. After the results, he will decide whether to prescribe this element in therapeutic doses. Without a detailed study, it is risky to increase the amount of the drug, since it is poorly excreted from the body and is dangerous in case of an overdose.

Other specialists

It is very simple to remember which doctors should be taken at 3 months. Mandatory - three: pediatrician, neurologist and orthopedist. But you may need to see other narrow specialists. Especially if before that there were suspicions about the presence of any pathology.

The surgeon at the first examination evaluates:

• how developed is the umbilical ring;
• whether there are diseases of the chest or abdomen;
• whether there is an umbilical or inguinal hernia;
• Have the testicles descended in boys?

If one of these problems was identified during a visit to the doctor at 1 month, then he will prescribe a second appointment. When it comes to umbilical hernia, then the specialist needs to check the effectiveness of the actions recommended by him. In situations where the boys did not descend before birth or shortly after one or both testicles, constant monitoring is needed. Sometimes you can not do without surgery, but it will be done later, the child should be older.

Perhaps a visit to the optometrist. He checks the fundus and the reaction of the pupils to light, looks at the condition lacrimal ducts. If they are underdeveloped, then it may be recommended special massage. Also, the doctor may decide on the need for their punching.

Another important specialist- ENT. He checks the condition of the ears, throat and nose. If he has any doubts about the acuity of the baby's hearing, then he can conduct an audiological screening. This method allows you to identify hearing loss in the very early age. If hearing loss is suspected, the doctor will refer you to an audiology center that specializes in such problems. Timely diagnosis will make it possible to begin rehabilitation in order to prevent delays in mental and speech development.

It is the responsibility of parents to look after the health of their children. So you can't ignore scheduled checkups doctors so as not to miss anything important. First of all, you need to go to the pediatrician. He will tell you which other specialists should be visited at 3 months or another age and which tests to pass.

What is included in the competence of a pediatric orthopedic doctor

A scheduled visit to the orthopedist will help check normal development and health of the musculoskeletal system, timely cure and correct violations. The orthopedist prescribes treatment in accordance with the analysis of the diagnosis, causes and severity of the disease.

What diseases does a pediatric orthopedist deal with?

What organs does a pediatric orthopedist deal with?

When to Contact a Pediatric Orthopedist

1. Asymmetric gluteal folds in an infant.
2. Various leg lengths.
3. The baby turns his head to one side, tilts to one shoulder.
4. When the baby is placed on the feet, he leans on the inside or outer surface feet.
5. The child went later than peers
6. The child does not walk well after a year. Falls off while walking.
7. Lag in development up to a year. For example sat down after 6 months or stood up after 9 months or walked after a year.
8. Pain in the foot, knees, joints, lower leg, spine when walking or running.
9. Curvature of the arms or legs.
10. Brushes hurt, there are spasms in them when writing. Problems with fine motor skills.
11. The child gets tired when walking.
12. Clubfoot.

When and what tests should be done

What are the main types of diagnostics that a pediatric orthopedist usually performs?

Prevention of the development of postural disorders and scoliosis should be comprehensive and include:

a) sleeping on a hard bed in a prone or supine position;
b) correct and precise correction of shoes: elimination of functional shortening of the limb, which arose due to violations of posture; compensation of foot defects (flat feet, clubfoot);
c) organization and strict observance correct mode day (time of sleep, wakefulness, nutrition, etc.);
d) constant physical activity including walks, activities exercise, sports, tourism, swimming;
e) rejection of such bad habits like standing on one leg, wrong position bodies while sitting (at a desk, desk, at home in an armchair, etc.);
f) control over the correct, uniform load on the spine when wearing backpacks, bags, briefcases, etc.;
g) swimming.

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The specialty of an orthopedic doctor is a mystery for many parents. Let's find out what an orthopedist does and why children need to visit him.

The task of the orthopedist is to timely diagnosis and treatment of congenital and acquired disorders musculoskeletal system. In the first year of a child's life, the orthopedist is mainly involved in the diagnosis and treatment of congenital disorders.

AT ideal For the first time, an orthopedist should examine a newborn in the maternity hospital on the 3rd - 5th day of life. In this period Special attention refers to rather gross violations of the formation of the musculoskeletal system or intranatal (occurred during childbirth) injuries.

What can be recognized or suspected at this age?

Firstly, gross malformations of the laying and development of the musculoskeletal system, such as aplasia (absence) or hypoplasia (insufficient development) of the limbs or their segments, non-fusion hard palate(the so-called "wolf mouth") and similar deformations. Such congenital malformations, as a rule, are not isolated and are combined with multiple malformations. internal organs Therefore, such children require the closest and most comprehensive examination by other specialists.

Also at this time, small malformations are found - for example, syndactyly (fusion of fingers or toes together) or polydactyly (presence of additional fingers).

During the examination, the range of motion in the joints is checked and, just at this age, the orthopedist can identify, probably, the most important one both in terms of frequency of occurrence and severity of consequences in the absence of adequate diagnosis and treatment of pathology - hip dysplasia, and, especially, congenital hip dislocation. It is at this age that when checking the range of motion in the hip joint, it is possible to identify the symptom of a “click” or, more correctly, “slipping” - a slight dislocation and reduction of the hip in the hip joint. Also in the maternity hospital, clubfoot is most often diagnosed - a pathology of the development of the ankle joint.

Of the intranatal injuries diagnosed at this age, the most common is cephalohematoma (hemorrhage under the periosteum of the bones of the cranial vault - more often parietal bone), characterized by an elastic swelling located within the boundaries of the bone, and a fracture of the clavicle, easily detected by palpation (palpation).

But, unfortunately, not all maternity hospitals have a full-time orthopedist. In this case, the neonatologist partially assumes its functions, and in case of suspicion of the presence orthopedic pathology the child is discharged from the hospital with a strong recommendation for an early examination by an orthopedist.

The first examination from the beginning of the observation of the child at the place of residence should occur at the age of 1 month. Examination at this age is also mainly aimed at identifying congenital orthopedic pathology or acquired intranatally. Of all the possible examinations by an orthopedist in the first year of a child's life, an examination at the age of 1 month is probably the most important in terms of timely recognition congenital pathology and timeliness of appropriate treatment.

What does an orthopedic examination include?

Before the start of the examination, anamnesis data are collected. Doctors are interested in all the nuances of the ongoing pregnancy, especially such as polyhydramnios, increased tone uterus, fetal presentation, how delivery took place. After collecting an anamnesis, they proceed to a clinical examination.

The child must be seen fully naked. First carried out visual inspection, in which the correct physique of the child, cleanliness and color are evaluated skin, the shape and position of the head, the proportions of body segments, the symmetry and position of the limbs at rest, as well as the volume active movements. This part of the inspection, despite its simplicity, gives a lot important information. Violation of the correct physique or proportion of body segments is often a marker of multiple congenital pathology or the presence genetic diseases. Deviation of the head away from the middle position may be one of the signs of torticollis, and the presence of cephalohematoma noticeably changes its shape. Forced or unnatural position of the limb is also important symptom for the diagnosis of congenital orthopedic pathology (as an example, strong external rotation lower limb at congenital dislocation hips).

Next, the doctor begins the manual - the most important - part of the examination, which reveals the volume of passive movements in the joints of the skeleton, soft tissue turgor and muscle tone. The areas of the joints and bone formations accessible for palpation are also examined by palpation (that is, by probing). This review gives the maximum useful information for the doctor because at this time restrictions of movements in the joints or, conversely, excessive mobility, the presence of bone or joint deformities, pain during movement, muscle protection and much more are detected. Based on the totality of the information received, called the clinical picture, the doctor decides on the appointment of additional examination methods. At present, the method is widely used ultrasound diagnostics, and ultrasound of the hip joints is even included in the protocol for the mandatory examination of children. If necessary, appoint additional methods surveys such as X-ray, biochemical analysis blood, as well as consultations of other medical specialists.

If the child is orthopedically healthy, then the next examination is scheduled at 3 months.

Inspection in 3 one month old largely duplicates the previous inspection both in terms of informational value and inspection methodology, but, of course, there are some peculiarities.

When examining a three-month-old child, an orthopedist has the opportunity to detect some pathologies that do not always appear in the first 1-2 months of life.

The most striking example of such pathologies may be muscular torticollis, which appeared as a result of birth injury, leading to partial break muscle fibers of the nodding muscle. Clinical picture with this type of torticollis, it often does not appear immediately, but only when an already significant scar is formed in the injury zone.

Taking an anamnesis at this age allows you to find out from parents about the appearance of motor skills in a child, as well as the presence of complaints about the limitation of the child’s movements, their pain, forced position limbs and the like.

During a clinical examination, the previous examination is also duplicated, which is supplemented by checking the dynamics of changes in muscle tone, the appearance of motor skills in a child.

If the examination of the child by an orthopedist at 3 months did not reveal any pathology, then in this case the next examination of the child should be performed at the age of 6 months.

Inspection at 6 months sums up the intermediate result of the development of the child. The main purpose of the inspection healthy child at this age - a test of the motor skills of the child. First of all, the child's ability to turn over, readiness for the "sitting" position is checked. In the presence of previous examinations by an orthopedist, the probability of primary diagnosis of congenital orthopedic disorders is quite small, so the focus is on the dynamics of the child's development and effectiveness medical measures.

But do not belittle the importance of a 6-month examination of a child by an orthopedist, since it is during examination at this age that the orthopedist can detect the presence of metabolic disorders in a child - such as rickets, phosphate - diabetes and the like. Also, during this examination, the child's readiness for the "sitting" position and other motor skills are revealed and recommendations are made to create conditions for the development of the child in the next six months.

Examination of a child at the age of 1 year is largely decisive.

Firstly, in healthy children at this time, the development of motor skills, the preparation of the child for walking, the ability of the child's musculoskeletal system to cope with increasing loads are summed up.

Secondly, at this age, it is possible to speak with almost complete certainty about the absence of congenital orthopedic pathology or to identify previously undiscovered congenital disorders(although this is already a late diagnosis).

Thirdly, in children who have previously been treated by an orthopedist, at this age, the effectiveness of the therapeutic measures taken is evaluated and the need for more aggressive methods or the question of the possibility of ending treatment is being decided.