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Pediatric orthopaedic surgeons choose to make the care of children the focus of their medical practice. They learn the unique nature of medical and surgical care of children from both advanced training and real-world experience in practice.

Pediatric orthopaedic surgeons are doctors who have completed the following education and training:

• Graduated from an approved medical school (typically 4 years)
• Graduated from an approved orthopaedic surgery residency program (typically 5 years)
• Completed additional subspecialty training in pediatric orthopaedics and/or pediatric spinal deformity (typically 1 year) 

A child's musculoskeletal problems are different than those of an adult.

Because children are still growing, the body's response to an injury, infection, or deformity may be quite different than that of a fully-grown person.

Sometimes, what is thought to be a problem in a child is just a variation of growth that will go away on its own with time. A good example of this is intoeing in a toddler. There are many problems that are unique to the growing body and are not found in adults.

Pediatric orthopaedic surgeons diagnose, treat, and manage the full range of musculoskeletal problems in children, including:

• Limb and spine deformities noted at birth or later in life (clubfoot, scoliosis, limb length differences in the legs or arms)
• Gait abnormalities (limping)
• Broken bones
• Torn ligaments (anterior cruciate ligament injuries, rotator cuff tears, etc.)
• Tendinitis and bursitis
• Bone, joint, and muscle infections 

Pediatric orthopaedic surgeons may work with doctors from other specialties as part of a medical-surgical team to treat complicated conditions such as:

• Bone tumors, including bone cancer
• Cerebral palsy
• Juvenile arthritis
• Muscular dystrophy
• Spina bifida

Children are not just small adults — physically, mentally, or emotionally. They cannot always express what is bothering them, or answer medical questions, or be patient and cooperative during a medical examination. They may also feel frightened or anxious just from being in a doctor's office or hospital.

Creating a comfortable and nonthreatening environment for children starts with the clinical space, and most orthopaedic surgeons' offices are arranged and decorated with children in mind. This may include:

• Specially-designed equipment
• Available toys, videos, and reading materials
• Child-friendly decor

In addition, pediatric orthopaedic surgeons are trained to examine and treat children in a way that helps them to be relaxed and cooperative. They also appreciate the worry and stress families can experience when a child has a musculoskeletal problem, and they have experience in communicating with anxious family members.

Each visit is tailored to the child's age and development.

Medical evaluation

Parents or guardians can expect to assist their child in answering questions or even providing all of the information. In addition to typical questions about the duration and type of symptoms, a pediatric orthopaedic surgeon will typically review information about a patient’s birth, development, and family history.

Physical examination

The examination is customized to the child's specific complaint and, just as important, their age. A toddler cannot be expected to answer questions or follow instructions the same way a teenager would. 

At times, a pediatric orthopaedic surgeon must find creative ways to examine young patients, such as observing them play, run, or handle objects.

To help children both feel safe and comply with the doctor's instructions, parents or guardians often participate in the examination — for instance, holding nervous young patients in their lap, or encouraging them to participate in various maneuvers.

Testing

Depending on the issue, the child's visit may include:

• X-rays, a CT scan, an MRI scan, or an ultrasound
• Casting or splinting
• A blood draw for laboratory testing

Parents or guardians typically can stay with the child for most, if not all, aspects of a clinic visit.

Treatment

A pediatric orthopaedic surgeon often has extensive experience in casting and bracing. Many fractures in children can be treated without surgery. Other conditions, such as hip dysplasia or clubfoot, may also be treated with casting and bracing rather than surgery.

When surgery is necessary, a pediatric surgeon has specialized training with implants and techniques unique to the growing body, such as guided growth for limb length differences or deformity.

Treatment planning for pediatric patients takes into account the family's situation in addition to the child's medical needs. Support services may be available to help families navigate the child's care. 

Pediatric orthopaedists have extensive and comprehensive training, and as well as expertise in dealing with children and treating their musculoskeletal problems. Your pediatrician or primary care doctor may have suggestions about whom to see.

If you feel that a pediatric orthopaedist is the right doctor for your child, the Pediatric Orthopaedic Society of North America (POSNA) contains a directory of members in every geographic location:

POSNA's "Find a Pediatric Orthopaedist" Directory 

All members of POSNA have completed a 1-year fellowship in pediatric orthopaedic surgery or devote at least 75% of their practice to treating children with pediatric orthopaedic problems.