Impact Of Obesity, Vitamin D Deficiency And Infections Discussion

Orthopedic Health Issues In Children

Orthopedic problem in children are considered as common problems. These problems could be related to various factors, such as, developmental, acquired or congenital. Pediatric orthopedics are also called as musculoskeletal problems According to the literature, not much focus has been given on the orthopedic problems in children. The major factors associated orthopedic problems in young children are associated with obesity, mental health issues, infections and unintentional injuries. Orthopedic problems leave the children to vulnerable conditions. There are many orthopedic problems, due to which developmental stages of the children are affected Impact Of Obesity, Vitamin D Deficiency And Infections Discussion.

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Orthopedic problems in children also influence emotional and social development of children in the later stage of life. Paper will discuss the various orthopedic problems in children between the age of 0 to 5 years. Paper will also discuss the wide array of literature related to the health issues and their consequences on the development of children. The discussion will include the impact of obesity, deficiency of vitamin D and infections on the growth and development of bones and muscles. It will be further followed with the developmental stage theories and national strategies and activities being carried out for the well-being of children.

Orthopedic health issues are related to the musculoskeletal problems. Such issues can affect the mobility and development of children. Some of the most common reasons of childhood orthopedic problems are lack of Vitamin D, obesity and unintentional injuries. Some of the congenital orthopedic problems are Metatarsus adductus (associated with the problem of forefoot adducted), Calcaneovalgus, which mainly occurs in the neonates (associated with abduction of the forefoot and increase of heel valgus, Planovalgus deformity (problem associated with cerebral palsy and surgery is unlikely to help in the severe conditions), Talipes equinovarus is associated with abnormalities of tibia, fibula and bones of the foot, which is also called as club foot. Oter orthopedic problems are associated with toes, legs, shoulders, neck, wrist, elbow and hips.

The prevalence of the orthopedic problems in the overweight children are common. Due to high weight, children often suffer from the problem of joints, muscles and other orthopedic issues. Studies have shown that severely overweight children are more likely to suffer from factures and musculoskeletal problems. The most commonly reported joint problem is the knee pain in case of obese children. The mobility impairments are often highly reported in the overweight children in comparison to children with appropriate weight. The number of children with obesity is increasing every year. It results in many health and social issues and impacts the developmental stages of child growth Impact Of Obesity, Vitamin D Deficiency And Infections Discussion.

Orthopedic Complications Associated With Obesity

Beginning of obesity in the early period of the childhood can intensify various physical and social problems in later life. The problems of joint, bones and muscles are often associated with weight, but problems of type 2 diabetes, pulmonary diseases, metabolic syndrome, cardiovascular diseases, depression and loss of self-esteem are also associated with obesity. Childhood obesity can have very harmful impact on the body and can impact various functions of the body. Early childhood is the age of bones growth and getting strength, but due to obesity bones can become weak and due to excess of weight the growth plate can be damaged.

The growth plates are associated with the developing cartilage tissue, which can be found at the end of the body’s arm, leg and other long bones. The main function of the Growth plates is to regulate and determine the length of the bone at maturity or full growth.  “Too much weight places excess stress on the growth plate which can lead to early arthritis, a greater risk for broken bones, and other serious conditions, such as slipped capital femoral epiphysis and Blount’s disease” (Taylor et al, 2006). Overweight children are more likely to experience the problem of Slipped capital femoral epiphysis (SCFE), Blount’s Disease, flat feet, fractures and mobility issues.

Quality of life is decreased in such children and co-morbid conditions are also found. Blount’s Disease is associated with the problem of bowing of the legs. Due to obesity the stress on the growth plate is increased and leg deformity occurs. In the less severe cases, this problem can be corrected at the early state and in early life years. This problem may require the tibial osteotomy surgery. Obesity results in weak bones and joints and children are more likely to suffer from unintentional injuries and fractures. The problem of flat feet is also very severe in children. Children in young age or in later age may have mobility issues and may be unable to walk long distances. Due to impaired mobility children may suffer from clumsiness, motor coordination problems and developmental coordination disorder.

Vitamin D is found in some plants, some fishes and mainly in the sunlight. The most common form of absorbing vitamin D is through sunlight. Skin absorbs vitamin D and transports it to liver to be changed in an active form. Vitamin D is very important for the growth and strength of the bones. Vitamin D in the body helps in absorbing higher level of calcium in the gut and helps in maintaining the adequate balance of concentrations phosphate and calcium. This adequate balance is important for mineralization of the bones that on the other hand prevents hypocalcemic tetany. Deficiency of vitamin D is caused by the inadequate intake of the nutrition and less exposure to sunlight. Deficiency results in very severe condition where the bone marginalization is impaired and bone softening disease, which also include formation of rickets in children. The first year of life is very significant in the child’s development. During the first year child learns to stand on his feet with little support. 1-2 years of age is the time when child starts walking without support. Lack of vitamin D and calcium can significantly impact the bone development and motor skills Impact Of Obesity, Vitamin D Deficiency And Infections Discussion.

Obesity And Orthopedic Issue In Children

Calcium is very important element in formation of bones. Due to deficiency of vitamin D, impaired absorption of the calcium occurs and children suffer from weak bones and impaired bone growth. “This hypocalcemia gives rise to secondary hyperparathyroidism, which is a homeostatic response aimed at maintaining, initially, serum calcium levels at the expense of the skeleton” (Gupta et al, 2014). The marginalization defect of skeleton occurs in children due to this deficiency. Rickets is the disorder or the disease associated with the growth of the bones. The matrix growth plates are un-marginalized, which occurs at the fusion of epiphyses (Gupta et al, 2014). Since the osteoid and cartilages of the growth plate continue to grow, and the process of marginalization is inadequate, the growth plate becomes thickens and results in orthopedic problems related to widening of ankles and wrists. The study further states that “Exclusively breast fed infants, children who do not like to drink milk, have milk allergy and on vegan diet are at risk. Children with certain chronic diseases including cystic fibrosis, celiac disease, liver diseases and children on anti seizure medication may not be able to absorb vitamin D well and can also be at risk of rickets” (Ward et al, 2007).

The most common joint infection occurring in the case of children is mainly due to pyogenic organisms. This inflectional mainly occurs in young children at the metaphysical regions of the big or long bones. Osteoarticular tuberculosis can be discussed in terms of Tuberculosis of joints, bone tuberculosis and spinal tuberculosis. Infection in the joints and bone are often seen as the secondary, as the primary focus is often the infection in the lungs and lymphatic glands. Such infections are caused due to poor living conditions and malnutrition. Children with immunodeficiency are more prone to get such tuberculosis.

Tuberculosis can affect any kind of joints or bones in the body of children. Intra-articular tuberculosis is associated with the bone lesions. Tubeculosis lesion affects the mobility of the body and it is also associated with intense sclerotic activity. Tubeculosis of the joints mainly includes the big joints of the body. “The child complains of pain in the joint, aggravated by movement, and often wakes ‘up at night because muscle spasm gets reduced and causes pain. It is classically called as “night cries”. Low- grade fever, loss of weight and appetite are some of the symptoms of generalized toxemia usually seen” (Standard Treatment Guidelines For Orthopedics, 2010). The movement of the joints can cause pain and elicit muscle spasm can occur. In the later stage of this infection, the movement may be totally restricted.

Vitamin D Deficiency And Orthopedic Problems

0-5 years of the age is the developmental age of the children, during which their teeth, bones and muscles develop. When the child is born, the bones and muscles are soft. With the growing age, calcium starts depositing on the bones and makes them stronger. The chances of fractures are very low in the initial childhood period. The first five years of age are for the physical developments. The joint and bone disease, infections and deficiencies of vitamin D can affect the developmental milestones (Pigrau-Serrallach & Rodríguez-Pardo, 2013). The motor skills of the children grew in this age, which are affected by the orthopedic health issues. This results in deformation of the bones and mobility.

According to the theory of social emotional development, 3-5 years of age is the time when children start making social contacts and emotional contacts (Darling-Churchill & Lippman, 2016). According to the study of Yates et al (2008) children between the age of 0-5 “form close and secure adult and peer relationships; experience, regulate, and express emotions in socially and culturally appropriate ways; and explore the environment and learn — all in the context of family, community, and culture”. Children start exploring the environment around them. Many foundational skills related to socialization and expression of emotions is developed on this stage. Orthopedic issues can restrict such development and child’s self-esteem, confidence and control can be affected in later stage (Yates et al, 2008)Impact Of Obesity, Vitamin D Deficiency And Infections Discussion.

The primary healthcare facilities of Australia are very broad. Many efforts are being made of the physical well being of children in Australia. Government has offered the National Physical Activity Recommendations for Children 0-5 Years, so that children could achieve appropriate weight, build strong muscles and bones, develop social skills and improve balance and mobility in children under the age of 0-5 (National Physical Activity Recommendations for Children 0-5 Years, n.d.). Government has provided many strategies and recommendation for the physical health activities of toddlers and pre-schoolers. Child Health and Wellbeing Plan is also promoting strategies for the physical well being of children (Hill et al, 2011). The study of Hill et al (2011), states that children are most vulnerable towards physical health issues and injuries. Therefore, the Standards for the care of children and adolescents in health services recognize the medical and psychological needs of the patients. Providing appropriate pediatric care is very complex due to the involvement of developmental and dependency issues (Lacey, Smith, & Cox, 2008). Due to the cognitive and physical development the need of children towards primary health care changes over time. Therefore, it is important to provide more approachable care to children with orthopedic issues.

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Conclusion:

The main focus of the paper was to address the issue of orthopedic problems in the children between the age 0-5. The children between these age groups are very young and have high dependency on the care givers. The developmental stage of the children between 0-5 years can be divided between toddlers and pre-schoolers. Paper discussed the various reasons of orthopedic problems among children of very young age. Paper also discussed that how these problems can impact the growth, development and cognitive development of children. The main reasons of common orthopedic problems among children are obesity, deficiency of vitamin D and bone infections. The orthopedic issues in children could be environmental, congenital and acquired. Children require more focus in the primacy care facilities for better future and health. Impact Of Obesity, Vitamin D Deficiency And Infections Discussion