Orthopaedics

The Children’s Orthopaedic Department is a multidisciplinary service offering a full range of treatment to children with orthopaedic problems. It is a tertiary referral centre for Norfolk and the surrounding hospitals.

The department is currently expanding with an aim to provide high quality service to the children of Norfolk as close to home as possible. Links have been developed with the Queen Elizabeth Hospital, King’s Lynn and there are formal planned links with the James Paget University Hospital in Gorleston. We also provide teaching and support both within the hospital setting and to health professionals and organisations in the community.

Jenny Lind Gull 3


Clinical Team

The Children’s Orthopaedic department has a team health professionals looking after all aspects of patient care. The team consists of specialist consultants, senior Physiotherapy  and nurse specialists. All team members work closely together to provide a comprehensive and seamless service to children and families with orthopaedic conditions. Pre-operative planning and post-operative after care for families across the region is carefully planned, with our specialist nurse and therapy staff liaising with health care professionals from King’s Lynn, JPUH, Ipswich and the West Suffolk in Bury St Edmunds.

The core multi-disciplinary team comprises the following:

Consultants

  • Rachael Hutchinson Paediatric Orthopaedic Surgeon
  • Anish Sanghrajka Paediatric Orthopaedic Surgeon
  • Anthony Catterall Paediatric Orthopaedic Surgeon (normal variant clinics only)

Specialist Nurse/Physiotherapy Jan Wilkins – Paediatric Orthopaedic Nurse Specialist

  • Fran Sutton – Extended Scope Physiotherapy
  • Vicky Easton – Extended Scope Physiotherapy

PAs/Secretaries

  • Nicky Bishop
  • Kelly Tilbury

Services we provide

We run three busy consultant clinic lists each week and two surgical lists. Our outpatient clinics are held in Jenny Lind Outpatients where everything is geared to the needs of children. We have close links with the Children’s Assessment Unit and Children’s Day Ward. There is also 24-hour cover with a paediatric orthopaedic surgeon and a paediatric anaesthetist on-call at all times if any emergency surgical intervention is required.

General Paediatric Orthopaedic Service

Children are not just ‘mini-adults’, they have many developmental, growth and maturational processes occurring within the skeletal and muscular systems. There is a broad spectrum of orthopaedic problems specific to the growing skeleton.

Our specialist consultants provide diagnosis and care for a wide range of problems such as:

  • Perthes Disease
  • Slipped Upper Femoral Epiphysis
  • Skeletal dysplasias
  • Osteomyelitis
  • Septic arthritis
  • Scheuermanns Disease
  • Osgood Schlatters Disease
  • Severs Disease
  • Trauma – broken bones, rupture ligaments etc.
  • Arthrogryposis
  • Foot and ankle pain….. And many more

Normal Variant Clinic

As a child grows there are quite marked changes in appearance of the body and in limb alignment. Often these are extremes of developmental ‘norms’, occasionally there is an underlying problem. We offer a thorough assessment service for families of children with concerns such as ‘knock knees’, ‘flat feet’, ‘pigeon toes’, ‘bow legs’ etc.

Developmental Dysplasia of the Hip / Pavlik Harness clinic

All babies have their hips checked just after they are born. Babies that are born with unstable hips can expect excellent results from a relatively short spell of treatment in a Pavlik Harness. We run a weekly clinic to treat babies with hip problems and to support parents during their child’s time in the harness.
We work closely with the radiologists and the staff who carry out neonatal examinations to offer a service that is as worry free and responsive as possible.

Jenny Lind puffins


Ponseti Clinic

A weekly clinic is held for babies and young children with foot problems such as talipes equino varus (‘club foot’). A team of specialist Physiotherapy  have expertise and experience in the Ponseti method of treating clubfoot. They work alongside Mrs Hutchinson to provide a comprehensive service for any child affected by positional or structural foot deformities.

Limb Reconstruction Service

We run a Regional Limb Reconstruction Service for children with a wide range of limb deformities or leg length inequality – these can be the result of complex trauma or certain orthopaedic conditions. Consultant Orthopaedic Surgeons Rachael Hutchinson and Ben Davis along with a team of Specialists run quarterly clinics in partnership with families requiring expertise in managing their condition and possibly, reconstructive surgery.

This will often take the form of an external frame built with a range of tools and parts that can be adapted to the individual needs of the child. This process takes time, hard work and commitment from the child and family but the results can be dramatic, a limb can be extended by up to a quarter or straighten bones and joints that were previously misshapen.

Neuro-disability multidisciplinary clinic

Scoliosis Clinic:

A weekly clinic led by orthopaedic consultants Mr Crawford, Mr Lutchman and Mr Rai provides assessment, monitoring and if required surgical intervention to children who present with a scoliosis or other complex spinal problems. They have close links with the radiology department so that specialist X-ray films and scans are available as necessary.

For more information on Scoliosis and to watch our patient journey video visit the Scoliosis page

Physio rehabilitation including hydrotherapy

We have a dedicated team of physiotherapists who specialise in the care and treatment of children and young people. This may involve helping with rehabilitation following orthopaedic surgery, helping with management of chronic orthopaedic conditions or advising and treating children with acute injuries. Physiotherapy  is generally provided on-site at the Jenny Lind; whilst a patient on Buxton Ward or in the NNUH hydrotherapy pool but the Physiotherapy  team also work closely with local schools, nurseries and colleges and advise and help where appropriate. For those patients at a later stage of rehabilitation we offer physiotherapy sessions at Carrow Park in our adolescent sports rehabilitation groups.

We link in with the paediatric rheumatology team regularly, sharing care of children with bone and joint infections, osteogenesis imperfect, arthrogryposis and other complex conditions. We have a fortnightly musculoskeletal multidisciplinary X-ray meeting, which includes all those involved in the care of children with musculoskeletal problems and provides a forum to discuss cases.

How you can access our services

Access to our service is via a GP referral or another Consultant Specialist.

Contacts

  • Nicky Bishop (secretary) 01603 286710
  • Kelly Tilbury (secretary) 01603 286596
  • Jan Wilkins (nurse Specialist) 01603 287266
  • Fran Sutton/Vicky Easton (physiotherapists) 01603 286333

Fax: Paediatric Orthopaedics 01603 286522

Direct:

Jan Wilkins (nurse specialist) pager 0298 via switchboard (01603 286286)

Useful numbers

  • Red Cross services 01603 426361
  • In Car Safety Centre 01908 220909, Milton Keynes
  • BDF newlife 01543 468888
  • RoSPA (Royal Society for the Prevention of Accidents) 0121 2482000

Research

Research activities are on-going within the department at a local and national level.

Awards

Nurse Specialist nominated for Patient Choice award 2009
Physio and Ponseti team nominated for Patient Choice award 2011

Clinical Guidelines

  • Pin-site Care
  • Hoop traction
  • Developmental Dysplasia of the Hip
  • Child with a Limp
  • Fracture femur

Information sheets

  • Care of your child in a Hip Spica Cast
  • General Plaster Care

Normal variants:

  • In toeing
  • Flat feet
  • Knock Knee/Bow legged
  • Care of baby in plaster
  • Care of baby in pavlik harness
  • Walking with crutches

Useful web links