Question 1

At what age should I have my child's feet checked?

Accepted Answer

An orthopaedic evaluation can be useful at any age if you notice something unusual. For flatfoot, a visit is generally recommended after 5-6 years if there is a marked persistent reduction of the plantar arch or if the child complains of pain or fatigue.

Question 2

When should I worry about my child's bowed or knocked knees?

Accepted Answer

Varus (bow legs) and valgus (knock knees) are part of the normal evolution of lower limbs. Varus is typical until 2 years, then legs tend toward valgus which corrects by 7-8 years. Consult if the deviation is very marked, asymmetric, worsening, or associated with pain.

Question 3

How do I book an appointment?

Accepted Answer

Appointments are held at ASST Gaetano Pini-CTO in Milan. You can book by calling the Regional Private Practice Call Center 800 890 890 or contacting me via email to assess availability based on the clinical situation.

Question 4

My child got hurt playing: when should we go to the Emergency Room?

Accepted Answer

It is advisable to go to the Emergency Room in case of: visible limb deformity, inability to move or bear weight on the limb, significant rapidly increasing swelling, intense unmanageable pain, tingling or loss of sensation, pallor or coldness of the limb.

Question 5

What should I bring to the first visit?

Accepted Answer

It is useful to bring: child's health card, any previous exams (X-rays, ultrasounds, MRIs), documentation from past specialist visits, a list of questions you want to ask. Dress the child in comfortable clothes that allow examination of the joints.

Question 6

My child has scoliosis: is it serious?

Accepted Answer

Adolescent idiopathic scoliosis is relatively common. Severity depends on the curve angle (measured by Cobb angle), age and skeletal maturity. Mild curves require only monitoring, while moderate curves may need a brace. Only a small percentage requires surgical treatment.

Question 7

My child is limping but has had no trauma: what could it be?

Accepted Answer

Limping without trauma always requires evaluation. Causes can be multiple: transient synovitis (most common and benign), Perthes disease, SCFE, infections, inflammatory conditions. If limping is associated with fever, refusal to bear weight, or intense night pain, urgent evaluation is advisable.

Question 8

At what age is it best to operate on clubfoot?

Accepted Answer

Ponseti treatment usually starts in the first weeks of life with serial casts. An Achilles tenotomy is a small surgical procedure used when equinus remains after the other components have been corrected; its timing depends on correction, not a fixed age. The team explains the anaesthesia and care required. A foot abduction brace then maintains correction: initially for most of the day, followed by night-time and nap use according to the prescribed programme. More extensive surgery is reserved for selected resistant or recurrent deformities.

Question 9

Do orthotics really work?

Accepted Answer

Orthotics can be useful in selected cases to reduce symptoms or improve function. However, they do not 'correct' the foot shape during growth. The decision on whether to prescribe orthotics should always be evaluated case by case during a specialist visit, considering the child's specific clinical situation.

Question 10

My child can't move their arm after being pulled: what should I do?

Accepted Answer

Nursemaid's elbow is one possibility, particularly in a young child after a pull on the hand, but a fracture or another cause cannot be excluded at home. A child who stops using the arm needs prompt assessment; do not try a reduction yourself. Go to the emergency department for deformity, marked swelling, fever, severe pain, or a pale, cold or numb hand. Avoid pulling children by the hands or forearms.

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