Come scegliere un ortopedico pediatrico a Milano?

L'ortopedico pediatrico si occupa esclusivamente dello scheletro in crescita. A differenza dell'ortopedico dell'adulto, conosce le varianti fisiologiche dell'età evolutiva: molte situazioni che sembrano "problemi" sono in realtà fasi normali della crescita. È utile rivolgersi a uno specialista con formazione dedicata alla pediatria, esperienza clinica continuativa con neonati, bambini e adolescenti, e attività in strutture ospedaliere di riferimento.

Quando portare il bambino dall'ortopedico pediatrico?

Le situazioni più comuni che meritano una valutazione specialistica sono: zoppia improvvisa, dolore persistente a piedi, ginocchia o schiena, piede piatto oltre i 6-7 anni, asimmetria delle spalle o del tronco (sospetta scoliosi), cammino sulle punte dopo i 3 anni, e dolore al tallone o al ginocchio nei giovani sportivi. Nel dubbio, una visita è sempre preferibile all'attesa.

Quanto costa una visita ortopedica pediatrica a Milano?

Il Dott. Priano riceve in regime di libera professione intramoenia (ALPI) presso l'Istituto Gaetano Pini e l'Ospedale CTO di Milano. L'appuntamento si fissa tramite il Call Center Regionale Libera Professione 800 890 890, canale aziendale/regionale, oppure selezionando uno slot su MioDottore, piattaforma esterna e non canale istituzionale dell'ASST: gli appuntamenti selezionati online vengono successivamente registrati nel sistema CUP aziendale prima della visita. Non è necessaria l'impegnativa; tariffa, pagamento e documentazione fiscale sono gestiti esclusivamente da ASST Gaetano Pini-CTO, che rilascia regolare ricevuta.

Quali patologie tratta l'ortopedico pediatrico?

Le patologie più frequenti includono piede piatto, scoliosi, displasia dell'anca nel neonato, ginocchio valgo e varo, cifosi (dorso curvo), tallonite (malattia di Sever), dolore al ginocchio (Osgood-Schlatter), torcicollo del neonato, e fratture e traumi sportivi. L'ortopedico pediatrico si occupa anche dello screening neonatale dell'anca e della valutazione posturale negli adolescenti.

Serve la radiografia prima della visita?

No, nella maggior parte dei casi non è necessario arrivare con radiografie già fatte. L'ortopedico pediatrico valuterà il bambino clinicamente e prescriverà gli esami strumentali solo se necessari e mirati. Radiografie "preventive" spesso non sono utili e espongono il bambino a radiazioni non necessarie.

Exercise Sheet

Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.

1.Ankle mobility recovery
Ankle will be stiff after immobilization
ALPHABET: seated with foot raised, "write" all alphabet letters with toe tip - this moves ankle in all directions. KNEE-TO-WALL: standing facing wall, foot 5-10 cm away, bring knee to touch wall without lifting heel. Gradually increase distance.
Alphabet: 2 times. Knee-to-wall: 10-15 reps. 3 times daily
2.Band strengthening (4 directions)
Recover ankle muscle strength in all directions
With band wrapped around foot, perform movements against resistance: DORSIFLEXION (pull up), PLANTARFLEXION (push down), INVERSION (rotate inward), EVERSION (rotate outward). Start with light band, progress when easy.
3 × 15 reps each direction
3.Progressive proprioception
Recover balance - essential to prevent recurrence
Balance is often compromised after immobilization and must be retrained. PROGRESSION: Level 1 - single-leg balance, hard floor, eyes open. Level 2 - eyes closed. Level 3 - cushion/soft surface, eyes open. Level 4 - cushion, eyes closed. Progress only when stable for 30 seconds.
3 × 30 seconds per level

RED FLAGS - When to stop and contact the doctor immediately

Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:

Acute or sudden pain during exercise
Significant swelling after exercises
Pain that progressively worsens over days
Fever or general malaise
Difficulty walking or using the limb after exercises
Any neurological symptoms (tingling, numbness, sudden weakness)
Fever, redness or warmth of the joint, or inability to bear weight

In case of doubt, always prefer a check-up over continuing the exercises.

Back to Post-Trauma / Post-Cast

After ankle cast

3 exercises

Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation, based on age, diagnosis and stage of recovery.

Important: These exercises do not replace physiotherapy assessment and treatment when indicated.

Before You Start

Who is this guide for?

Children who had ankle/foot cast removed. Recovery of mobility and gradual weight-bearing resumption.

What you need

Clear floor space, mat or soft surface, comfortable clothing. Some exercises may require resistance bands or supports.

Suggested frequency

Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.

Common mistakes to avoid

•Performing exercises too quickly without control
•Pushing beyond the pain threshold
•Skipping days or doing occasional very long sessions
•Not warming up before strengthening exercises

⚠️ Red flags — when to stop and contact the doctor immediately

Stop exercises immediately and contact the specialist if any of the following occur:

Acute or sudden pain during exercise
Significant swelling after exercises
Pain that progressively worsens over days
Fever or general malaise
Difficulty walking or using the limb after exercises
Any neurological symptoms (tingling, numbness, sudden weakness)

In case of doubt, always prefer a check-up over continuing exercises.

Detailed Exercises

1
Ankle mobility recovery
Ankle will be stiff after immobilization
ALPHABET: seated with foot raised, "write" all alphabet letters with toe tip - this moves ankle in all directions. KNEE-TO-WALL: standing facing wall, foot 5-10 cm away, bring knee to touch wall without lifting heel. Gradually increase distance.
Alphabet: 2 times. Knee-to-wall: 10-15 reps. 3 times daily
2
Band strengthening (4 directions)
Recover ankle muscle strength in all directions
With band wrapped around foot, perform movements against resistance: DORSIFLEXION (pull up), PLANTARFLEXION (push down), INVERSION (rotate inward), EVERSION (rotate outward). Start with light band, progress when easy.
3 × 15 reps each direction
3
Progressive proprioception
Recover balance - essential to prevent recurrence
Balance is often compromised after immobilization and must be retrained. PROGRESSION: Level 1 - single-leg balance, hard floor, eyes open. Level 2 - eyes closed. Level 3 - cushion/soft surface, eyes open. Level 4 - cushion, eyes closed. Progress only when stable for 30 seconds.
3 × 30 seconds per level

After elbow cast

After finger/toe cast or immobilization

1.Ankle mobility recovery

2.Band strengthening (4 directions)

3.Progressive proprioception