The dream of every parent is to have a child born with no birth defects. Now a days, medicine has advanced so much that lot of congenital abnormalities can be diagnosed very early. Early management will lead the child to have a near normal life.
Common birth defects like clubfeet will show up as soon as the child is born. But problems like hip dislocation can be missed till child starts walking if we are not vigilant. If conditions like this diagnosed and treated early will have good quality of life. Literature suggests that late diagnosis will result in problem in later life.
One day, when I was busy in my out-patient clinic, parents from abroad brought their five year old daughter for consultation. When I examined and investigated, I found that she had dislocation of both hips. On further questioning, I came to know that they were advised not to treat till child becomes 12 years old. I had to do lot of explanation to convince them that reducing both hips early will give better quality of life. This misguided advise happens because of consulting Orthopedic surgeons with no formal training in Children's orthopedic problems.
After having spent 15 years of my career in UK and Ireland, initially as a trainee, then fellowship in Pediatric Orthopedics and Spine followed by consultant in Pediatric Orthpedics and Spine in one of the tertiary referral centre in Ireland, I move back to India in 2006. Since then, I am with Apollo Hospitals and was instrumental in setting up the Pediatric Orthopedic department when they opened the state of the art Children's Hospital in Chennai.
Since birth defects were my area of special interest, I was able to plan and perform this complex surgery on both hips of this child during their visit to India. This was done in two stages, one hip at a time. It involved in preparing the socket of the hip, open reduction and shortening of femur bone with plating to keep the hip in the socket. It nearly took 3 weeks for the child to get up and stand and 2 months to walk. Parents were thrilled to see their child walking and running like any other children. Now and then, they send me video of her playing around.
Reason for such complex surgery is because of late presentation. If hip dislocation is diagnosed at birth, it can be treated with Harness. Till the child is one year old, this can be managed with plaster cast. Any later diagnosis will end up with major surgery. In our institution, we always examine all newborn present with risk factors for hip dislocation. Sometimes clinical examination is supported by ultrasound examination.

Figure 1& 2. X-ray of both hips showing dislocation of hips in a 5 year old girl
Figure 3&4. Immediate post op x-ray and recent x-ray showing both hips well reduced


Located in the heart of Chennai, India, just a stone’s throw away from the flagship Apollo Hospital, the Apollo Children’s Hospital is a 80-bedded facility, offering the finest quaternary-care pediatric specialties in the country. The health needs of children are extremely unique and different
Children should not be treated as little adults as their anatomic and physiological development is different from that of adults. Therefore, their response to disease, injury and surgery is also different from adults. Orthopedic conditions, including birth and congenital defects (such as club foot or dislocated hip), require ongoing treatment and care from birth into adulthood. Management of children’s fractures differs significantly from adult fractures because of children’s growing bones and the presence of growth plates. Consequently, orthopedic services should be tailored to meet the needs of pediatric patients.
Pediatric orthopaedic surgeons in our hospital diagnose and manage children's musculoskeletal problems, such as:
• Limb and spine deformities noted at birth or later in life (clubfoot, hip dislocation, radial and ulnar club hand, scoliosis, limb length differences)
• Gait abnormalities (limping)
• Neuromuscular Disorders
• Broken bones
• Bone or joint infections and tumours
Dr. R. Sankar is a Paediatric Orthopaedic and Spine Surgeon at Apollo Children’s Hospitals, Chennai. Dr. R. Sankar has trained extensively in Orthopaedic Surgery in India and in the U.K.& Ireland. After completion of Intercollegiate fellowship in UK & Ireland, he underwent fellowship training in Paediatric Orthopaedics and Spine. During this period, he attended international courses and conferences relating to Pediatric Orthopedics and Spine. He also spent some time with Prof. Ponseti, who has pioneered in non surgical correction of Clubfeet, which is being practised throughout the world.
After completion of his training, he became Consultant in Our Lady's Hospital for Sick Children in Dublin, Ireland.After spending almost 15 years in UK & Ireland, he returned back to India. He works with patients and their families to develop a comprehensive and tailored treatment plan for each patient.

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abanastuff:
The dream of every parent is to have a child born with no birth defects. Now a days, medicine has advanced so much that lot of congenital abnormalities can be diagnosed very early. Early management will lead the child to have a near normal life.
Common birth defects like clubfeet will show up as soon as the child is born. But problems like hip dislocation can be missed till child starts walking if we are not vigilant. If conditions like this diagnosed and treated early will have good quality of life. Literature suggests that late diagnosis will result in problem in later life.
One day, when I was busy in my out-patient clinic, parents from abroad brought their five year old daughter for consultation. When I examined and investigated, I found that she had dislocation of both hips. On further questioning, I came to know that they were advised not to treat till child becomes 12 years old. I had to do lot of explanation to convince them that reducing both hips early will give better quality of life. This misguided advise happens because of consulting Orthopedic surgeons with no formal training in Children's orthopedic problems.
After having spent 15 years of my career in UK and Ireland, initially as a trainee, then fellowship in Pediatric Orthopedics and Spine followed by consultant in Pediatric Orthpedics and Spine in one of the tertiary referral centre in Ireland, I move back to India in 2006. Since then, I am with Apollo Hospitals and was instrumental in setting up the Pediatric Orthopedic department when they opened the state of the art Children's Hospital in Chennai.
Since birth defects were my area of special interest, I was able to plan and perform this complex surgery on both hips of this child during their visit to India. This was done in two stages, one hip at a time. It involved in preparing the socket of the hip, open reduction and shortening of femur bone with plating to keep the hip in the socket. It nearly took 3 weeks for the child to get up and stand and 2 months to walk. Parents were thrilled to see their child walking and running like any other children. Now and then, they send me video of her playing around.
Reason for such complex surgery is because of late presentation. If hip dislocation is diagnosed at birth, it can be treated with Harness. Till the child is one year old, this can be managed with plaster cast. Any later diagnosis will end up with major surgery. In our institution, we always examine all newborn present with risk factors for hip dislocation. Sometimes clinical examination is supported by ultrasound examination.

Figure 1& 2. X-ray of both hips showing dislocation of hips in a 5 year old girl
Figure 3&4. Immediate post op x-ray and recent x-ray showing both hips well reduced


Located in the heart of Chennai, India, just a stone’s throw away from the flagship Apollo Hospital, the Apollo Children’s Hospital is a 80-bedded facility, offering the finest quaternary-care pediatric specialties in the country. The health needs of children are extremely unique and different
Children should not be treated as little adults as their anatomic and physiological development is different from that of adults. Therefore, their response to disease, injury and surgery is also different from adults. Orthopedic conditions, including birth and congenital defects (such as club foot or dislocated hip), require ongoing treatment and care from birth into adulthood. Management of children’s fractures differs significantly from adult fractures because of children’s growing bones and the presence of growth plates. Consequently, orthopedic services should be tailored to meet the needs of pediatric patients.
Pediatric orthopaedic surgeons in our hospital diagnose and manage children's musculoskeletal problems, such as:
• Limb and spine deformities noted at birth or later in life (clubfoot, hip dislocation, radial and ulnar club hand, scoliosis, limb length differences)
• Gait abnormalities (limping)
• Neuromuscular Disorders
• Broken bones
• Bone or joint infections and tumours
Dr. R. Sankar is a Paediatric Orthopaedic and Spine Surgeon at Apollo Children’s Hospitals, Chennai. Dr. R. Sankar has trained extensively in Orthopaedic Surgery in India and in the U.K.& Ireland. After completion of Intercollegiate fellowship in UK & Ireland, he underwent fellowship training in Paediatric Orthopaedics and Spine. During this period, he attended international courses and conferences relating to Pediatric Orthopedics and Spine. He also spent some time with Prof. Ponseti, who has pioneered in non surgical correction of Clubfeet, which is being practised throughout the world.
After completion of his training, he became Consultant in Our Lady's Hospital for Sick Children in Dublin, Ireland.After spending almost 15 years in UK & Ireland, he returned back to India. He works with patients and their families to develop a comprehensive and tailored treatment plan for each patient.