[...]... lesion being discovered The discrepancy between radiological findings and clinical relevance is at its most extreme for degenerative changes of the spine In this situation the x-ray on its own is almost meaningless While the situation is not so extreme in pediatric orthopaedics, most findings can still only be assessed in connection with the clinical examination Diagnostic procedure In establishing the... spurt that occurs during puberty, since the increase in muscle cross-section lags behind the growth in height and the corresponding increase in muscle length Consequently, a certain amount of postural weakness is inevitable during this phase of development Yet it is precisely this poor posture that often causes perpetual conflicts with authority The constant nagging by parents exhorting the child to sit... stunted growth, the sole exception being Marfan syndrome I think it is likely that the decline in pediatric orthopaedic diseases since 1960 also has something to do with mobility and the associated increase in genetic intermixing After all, hip dysplasia had been common primarily in the Alpine countries of Austria, Switzerland, Fig 1.8 Average height of recruits in Switzerland from 18802000 The figures... are shown for the years 1952 and 1992 In 1952 the average height in the rural and mountainous canton of Appenzell was 7 cm (2.75 in. ) shorter than in the urban canton of Basel-City By 1992 the difference had fallen to just 2 cm (1 in. ) Increased genetic intermixing has not only resulted in an increase in the average height, but is also responsible for a decline in the frequency of congenital malformations... pioneering work in another field by establishing the worlds first orthopaedic institute in Orbe (Canton of Vaud, Switzerland) in 1780 This institute provided conservative treatment exclusively for children with orthopaedic conditions In Germany, Johann Georg von Heine, was the first to open an orthopaedic hospital, in 1812 in Wỹrzburg In France, Jacques Mathieu Delpech founded an orthopaedic institute... Chapter 1 ã General in 1825 in Montpellier, while Jules-Renộ Guerin and CharlesGabriel Pravaz began their work in an orthopaedic hospital in Paris in 1826 Delpech (17771832) is also considered to be the actual founder of the science of orthopaedics In England an orthopaedic institution was founded in 1837 by William Little The first American orthopaedic institute was inaugurated in Boston in 1839 by John... 1.8 (Ireland, Finland), in certain Northern European countries This trend is exacerbated by the so-called ằsecondary pill dipô, i.e the fact that, as a result of the drop in the birthrate in the 1960s, there is now a shortage of potential mothers for bringing children into the world But not only will the number of children decline The incidence of certain diseases is definitely falling, even though... hand over the original files Bear in mind that everything you The patient and the parents are entitled to view the records and make copies of them record in writing may be viewed by the parents and should be worded accordingly Derogatory remarks are completely inappropriate If you frequently find yourself being irritated by patients or parents and think disparagingly of them, then pediatric orthopaedics... neglecting to do something, i.e not starting a treatment at the right time, and thus be reproached by the child in later life as an adult The parents fear, for example, that the intoeing gait may persist for life, that flat feet may make their child ineligible for military service in later life or that the knee pain experienced after a football training session could be an early sign of an imminent sporting... Czechoslovakia and Southern Germany, whereas in Italy only the mountainous region of Lombardy was affected Inbreeding in these regions was evidently greater than in those countries with coastal borders The incidence of hip dysplasia in English-speaking countries back in the 1960s was about as low as the current figure for the Alpine countries 25 1.3 ã Changing patterns of pediatric orthopaedic diseases Developments, . w0 h0" alt="" Fritz Hefti Pediatric Orthopedics in Practice Fritz Hefti Pediatric Orthopedics in Practice Co-Authors: Reinald Brunner, Carol C. Hasler,. that occurs during puberty, since the in- crease in muscle cross-section lags behind the growth in height and the corresponding increase in muscle length.