Chapter 21: Musculoskeletal Disorders in Children

Musculoskeletal Disorders in Children explores critical concepts such as the presence of the physis or growth plate, the periosteum's role in rapid healing and remodeling, and the specific vulnerabilities of the immature skeleton to injuries like torus, greenstick, and supracondylar fractures. The text delves into the nursing management of traumatic injuries, emphasizing neurovascular assessments using the five Ps—pain, pulse, pallor, paresthesia, and paralysis—along with protocols for cast care, traction application, and postsurgical monitoring. A significant portion of the chapter describes congenital and developmental abnormalities, including clubfoot treatment via the Ponseti method, the diagnosis and management of developmental dysplasia of the hip (DDH) using the Pavlik harness or spica casting, and rotational deformities like tibial torsion and metatarsus adductus. Furthermore, the content covers acquired conditions affecting mobility and growth, such as Legg-Calvé-Perthes disease, slipped capital femoral epiphysis (SCFE), and various forms of scoliosis requiring bracing or spinal fusion. The chapter also addresses inflammatory and infectious processes like juvenile idiopathic arthritis (JIA), osteomyelitis, and septic arthritis, alongside genetic disorders such as osteogenesis imperfecta, outlining the necessary pharmacological interventions, physical therapy needs, and family education strategies required to optimize patient outcomes and prevent long-term disability.