Shoulder, Elbow and Hand
Conditions Diagnosed & Treated
Below is an outline of some of the major paediatric orthopaedics disorders that we specialise in, but typically most paediatric orthopaedic conditions that warrant a specialist referral can be successfully investigated through our team. If your child is suffering from any orthopaedic or sport issue and are looking for definitive medical support then please let us know.
Common Paediatric Conditions
Shoulder Instability
This refers to the condition where the shoulder joint feels out of its normal position, often leading to pain and an inability to move the shoulder. Instability can occur as a result of a dislocation.
First Time and Recurrent Shoulder Dislocation
A first-time shoulder dislocation typically occurs due to a significant injury or trauma, while recurrent dislocations happen in a shoulder that has previously dislocated, often with less force or trauma needed for subsequent dislocations.
Labral Tears, Bankart and Hill Sachs Lesions
Labral tears involve damage to the cartilage rim surrounding the shoulder socket. A Bankart lesion is a specific type of labral tear that occurs with shoulder dislocations, where the labrum and attached ligaments detach from the socket. A Hill-Sachs lesion is a compression fracture of the humeral head that often accompanies a shoulder dislocation.
Apophysis Injuries
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Acromial Injuries: Injuries to the acromion, which is the outermost point of the shoulder blade or scapula, can involve fractures, impingement syndromes, or arthritis. These injuries can result from trauma, overuse, or degenerative changes in the shoulder joint.
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Medial Epicondyle Injuries: These injuries involve the medial epicondyle, a bony prominence on the inside of the elbow. Common in throwing athletes, these injuries can range from inflammation (medial epicondylitis) to fractures, often caused by repetitive stress or acute trauma to the elbow area.
Acromial and medial epicondyle
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Acromial Injuries: Injuries to the acromion, which is the outermost point of the shoulder blade or scapula, can involve fractures, impingement syndromes, or arthritis. These injuries can result from trauma, overuse, or degenerative changes in the shoulder joint.
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Medial Epicondyle Injuries: These injuries involve the medial epicondyle, a bony prominence on the inside of the elbow. Common in throwing athletes, these injuries can range from inflammation (medial epicondylitis) to fractures, often caused by repetitive stress or acute trauma to the elbow area.
Trigger finger and thumb
Trigger finger and thumb is a condition where a child’s finger or thumb gets stuck in a bent position, then straightens with a snap, similar to a trigger being pulled and released.
Fractures and Dislocations
Salter Harris fractures or growth plate injuries
Salter-Harris fractures are injuries to the growth plate area of a child’s bone and are categorised into five types, each varying in severity and impact on future bone growth.
Clavicle fractures
Clavicle fractures, commonly known as broken collarbones, are frequent injuries in children and young adults, often resulting from falls or direct impact to the shoulder area.
Humeral fractures
Humeral fractures refer to breaks in the humerus, the long bone in the upper arm, and can occur at various points along the bone, often due to falls or direct trauma.
Supracondylar fractures
Supracondylar fractures are common elbow injuries in children, involving a break just above the elbow joint, and are often caused by a fall onto an outstretched hand.
Forearm fractures
Forearm fractures involve a break in one or both of the bones of the forearm (the radius and ulna), typically resulting from falls, sports injuries, or direct trauma to the arm.
Radius and ulna fractures
Radius and ulna fractures refer to breaks in the two long bones of the forearm, often occurring simultaneously due to direct impact or a fall on an outstretched arm.
Hand fractures or injuries
Hand fractures or injuries encompass a range of conditions affecting the bones, joints, and soft tissues of the hand, commonly resulting from falls, sports activities, or direct blows.
Avulsion Injuries
pectoral girdle
The pectoral girdle, also known as the shoulder girdle, is a set of bones in the upper body that provides support and attachment points for the upper limbs. It consists of the clavicles (collarbones) and the scapulae (shoulder blades), and plays a crucial role in providing mobility and stability for the arms and shoulders, enabling a wide range of movements.
Elbow
Elbow avulsion injuries occur when a tendon or ligament is pulled away from the bone, often taking a piece of the bone with it. This type of injury is commonly seen in the elbow due to forceful or sudden movements, particularly in sports or activities that involve throwing motions. They can be quite painful and may require immediate medical attention for proper healing and to restore elbow function.
Hand
Hand avulsion injuries involve the tearing away of a tendon or ligament from the bone in the hand, often accompanied by a small fragment of bone. These injuries typically result from a forceful pull or trauma to the hand, and can occur in various scenarios such as sports injuries, falls, or work-related accidents. Due to the complex structure of the hand, these injuries require prompt and specialised medical attention to ensure proper healing and to maintain hand function.
Ligament Injuries
Shoulder Dislocation / Instability
In pediatrics, ligament injuries related to shoulder dislocation or instability often involve the stretching or tearing of the shoulder ligaments in children, leading to a dislocated joint and compromised joint stability, which can affect their growing musculoskeletal system.
Acromioclavicular Joint Injury (ACJ)
Acromioclavicular Joint Injury (ACJ) typically involves damage to the ligaments connecting the clavicle and the scapula at the acromion, which can range from mild sprains to complete dislocations, affecting the shoulder’s stability and movement in children.
rotator cuff injuries or tears
In children, rotator cuff injuries or tears involve damage to the group of muscles and tendons that stabilise the shoulder joint, often resulting from overuse or acute injury, leading to pain, weakness, and limited shoulder movement in paediatric patients.
Nursemaid’s Elbow / “Pulled elbow”
Nursemaid’s Elbow, also known as “Pulled Elbow”, is a common injury where the radius bone in the elbow becomes partially dislocated, often due to a sudden pull on the child’s extended arm, leading to pain and limited arm movement.
Tendon Injuries
Rotator Cuff Injuries / Tears
In paediatric patients, tendon injuries such as rotator cuff injuries or tears typically involve damage to the tendons stabilising the shoulder joint. These injuries in children can result from overuse, particularly in sports, or from acute injury, leading to shoulder pain, weakness, and reduced range of motion.
Impingement Syndrome
Impingement Syndrome as a tendon injury involves the compression of the tendons in the shoulder between the bones, often due to repetitive overhead activities. This condition can cause pain, swelling, and limited movement in the shoulder area of children.
Bicep tendon Injuries
In children, bicep tendon injuries involve damage to the tendon that attaches the bicep muscle to the bones in the shoulder and elbow. These injuries can occur due to overuse or trauma, leading to pain, swelling, and reduced function in the affected arm.
Tennis/Golfers Elbow
In children, conditions like Tennis Elbow (lateral epicondylitis) and Golfer’s Elbow (medial epicondylitis) involve inflammation of the tendons in the elbow due to overuse, typically from repetitive wrist and arm motions. These conditions can cause pain and tenderness around the elbow joint.
Cartilage Injuries
Osteochondritis Dissecans
Osteochondritis Dissecans is a joint condition where a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. This can lead to joint pain and instability, often affecting the knees, elbows, or ankles in children and adolescents.
Osteochondral Defects
Osteochondral Defects refer to damage to both the bone and the cartilage in a joint, often caused by injury or lack of blood supply to the area. These defects can lead to pain, swelling, and joint dysfunction in paediatric patients.
Nerve Entrapment
Carpal Tunnel Syndrome / Median nerve
Carpal Tunnel Syndrome in children, a condition less common than in adults, involves the compression of the median nerve within the carpal tunnel of the wrist, leading to pain, numbness, and weakness in the hand and fingers.
Carpal Tunnel Syndrome / Ulna nerve
In children, Ulnar Nerve Compression, often occurring at the elbow or wrist, involves pressure on the ulnar nerve leading to symptoms like pain, numbness, and tingling, primarily in the ring and little fingers, and can affect hand coordination and strength.
Nailbed injuries
Nailbed Injuries
Nailbed injuries in children often result from direct trauma to the fingertip, such as crushing injuries or cuts, leading to damage to the nail and underlying structures, which can be painful and may require medical attention for proper healing.
What some of our patients say
Mrs EL
Thank you for taking great care of me throughout the whole operation process! My recovery has been much faster than anticipated and I am pain free after such a long time!