Group

Diseases

Intervention

Considerations

Emergencies

Neurovascular compromise

A gentle reduction, angioplasty, or emergency open surgery

Septic arthritis

Open joint drainage, antibiotic administration

Reevaluating the response through clinical exam improvement and decreased CRP

Compartment syndrome

Fasciotomy

3 As to doubt: more Analgesia for pain but no relief, Anxiety, and Agitation

Slipped capital femoral epiphysis

Emergency fixing surgery

Consider the risk of AVN of the hip

Open fracture

Immediate wound irrigation, debridement, and fracture stabilization

Do not forget antibiotics prescription and tetanus vaccination update

Overuse injury

Stress fracture

Hard-sole shoe, casting, repair surgery (irrigation and debridement), and antibiotics prescription if needed

Consider nail deformity and osteomyelitis

Osgood-Schlatter disease

Ice pack, anti-inflammatory drugs, activity restriction

Rule out the dangerous causes

Sever disease

Osteochondritis dissecans

Several months of activity modification and weight limitation, anti-inflammatory drugs

Arthroscopy fixation is needed in unstable cases

Toddlers

DDH

Open surgery

Foreign body

Removing the foreign bodies and starting antibiotics

Cover Staphylococcus, Streptococcus, and Pseudomonas if needed

Toddler fracture

Casting

4 weeks duration of treatment

Osteomyelitis

Surgical drainage and debridement, antibiotics prescription

Limb deficiency

Corrective surgery

Clubfoot

Spina bifida

Coxa vara

Protective treatment or corrective surgery

Association with metabolic bone diseases or osteomyelitis

3 - 10-year-old children

Legg-Calvé-Perthes disease

Anti-inflammatory drugs, controlled weight-bearing, activity limitation, and physical therapy

Casting and surgery if symptoms continue

Transient synovitis

7 to 10 days duration of improvement

Kohler disease

Consider the possibility of impaired blood flow and avascular necrosis

Charcot-Marie-Tooth disease

Corrective surgery

Equinus contracture

Idiopathic tight Achilles tendon

10-year-old children

Diskitis

Anti-inflammatory drugs, rest

Tumors

Surgical resection

Pediatric genetic evaluation is needed in some cases like osteochondroma

Tarsal coalition

Conservative treatment, temporary boot or cast, fusion or resection surgery in severe cases

Discoid meniscus

Conservative treatment, meniscectomy in severe cases

Juvenile Idiopathic Arthritis

(JIA)

Corticosteroid agents, referring to a rheumatologist

Malignancies

Immediate biopsy and surgery, referring to an oncologist