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Division of Orthopaedics

Programs and services

Bone Health ClinicBaby Hip Clinic  | Complex Spine clinic | Fracture Clinic  | Hip Follow-up Clinic  |  Idiopathic Toe-Walking ClinicPhysio Club Foot Clinic  |  Limb Reconstruction Clinic  | Multidisciplinary Musculoskeletal Tumour (MMT) Clinic | Orthopaedic Clinic |  Scoliosis Clinic
 



Bone Health Clinic 

This clinic is a weekly multidisciplinary clinic that runs with participation from orthopaedics, endocrinology and clinical genetics, with a focus on genetic bone diseases.

Baby Hip Clinic

The Baby Hip Clinic at SickKids is an inter-professional clinic that includes an orthopaedic surgeon, a physiotherapist practitioner, a senior secretary, fellows, residents, orthotists, clinic nurses and administrators. The clinic is designed to assess and treat babies with Developmental Dysplasia of the Hip (DDH). Babies with dislocated hips are ideally seen at the earliest available clinic date.

 All other babies are ideally seen around six weeks of age. Patients requiring treatment in a Pavlik Harness will be seen every one to four weeks to check progress and adjust the harness for growth. An orthotist will apply the harness and full treatment in the harness usually lasts 12-16 weeks. Patients requiring monitoring typically return to clinic four weeks after the initial appointment. Patients requiring operative management will be followed in a surgeon’s regular clinic.

Upon completion of treatment, babies are monitored and return to clinic in intervals of six months to three years (see Hip Follow-up clnic below).

For location and more see Baby Hip Clinic.

Complex Spine Clinic 

This clinic occurs once a month under the direction of orthopaedics and neurosurgery. 

Fracture Clinic

Our interprofessional clinic is devoted to the assessment and treatment of paediatric fractures. Referrals are triaged Monday to Friday, to determine your child’s plan of care. Based on the referral information, you will be given an appointment in our clinic, or instructed to follow up with your family doctor.

Typically, we see upper and lower extremity fractures, such as wrist, forearm, elbow, shoulder, thigh, lower leg and feet. We refer forearm buckle fractures to the family doctor for treatment.

Fracture Clinic is held four times a week by the residents and a specialty-trained nurse practitioner, with supervision from the orthopaedic staff surgeons.

For more see Fracture Clinic.

HIp Follow-up Clinic

The Hip Follow-up Clinic provides conservative management of children with developmental dysplasia of the hip (DDH). The Hip Follow-up Clinic is for graduates of the Baby Hip Clinic or first-time visits of children older than 1 year of age.

This clinic is held weekly. The fellow performs a comprehensive assessment including ultrasound on all follow-up infants in the clinic, providing real time education on developmental dysplasia of the hip. 

For location and more, see Hip Follow-up Clinic.

Idiopathic Toe-Walking Clinic 

The Idiopathic Toe-Walking Clinic is an interprofessional clinic that includes an orthopaedic surgeon, a physiotherapist, fellows, residents and orthopaedic technicians. The clinic assesses and treats children and adolescents with idiopathic toe-walking.  For location and more, see Idiopathic Toe-Walking Clinic

Limb Reconstruction Clinic

The Limb Reconstruction Clinic is for the planning and monitoring of complex deformity corrections and limb lengthening using state of the art methods of internal and external fixation.

Multidisciplinary Musculoskeletal Tumour (MMT) Clinic

The team that manages musculoskeletal tumours in children includes specialist sarcoma medical oncologists, a clinical oncology nurse practitioner, specialist diagnostic and interventional radiologists, pathologists, a specialist physiotherapist, an oncology social worker, clinic nurses and administrators, a clinical database manager and specialist orthopaedic oncology surgeons. We run a multidisciplinary musculoskeletal tumour clinic where we evaluate and expedite work-up of potentially malignant bone and soft tissue tumours. Referrals are quickly processed. 

Following thorough structural and functional imaging, a biopsy is often performed. Those tumours requiring chemotherapy are treated as per a Children’s Oncology Group protocol where possible. Those tumours requiring surgery are treated with intralesional, marginal or wide resection, based on the grade of tumour. Limb-sparing reconstructive procedures are usually possible. 

We aim to maximize function and undertake biological reconstruction with living tissue where possible, sometimes in collaboration with our plastic microvascular surgery colleagues. Reconstruction with state-of-the-art endoprosthetic implants is an alternative approach we utilize. Our group collaborates with the adult musculoskeletal group based at Mt. Sinai and Princess Margaret Hospitals across the road. We hold joint conferences and together maintain the tumour bank and collaborate on basic science and clinical outcomes research.

This clinic runs every week with orthopaedics, medical oncology, physiotherapy and plastic surgery. The combined Brachial Plexus Palsy Clinic runs once a month with plastic surgery and orthopaedics.

For more, see the Multidisciplinary Musculoskeletal Tumour (MMT) Clinic.

Orthopaedic Clinic

The Orthopaedic Clinic helps children with problems with their bones. For location and more, see Orthopaedic clinic.

Physio Club Foot Clinic

The Club Foot Clinic at SickKids is a multidisciplinary clinic designed to assess and treat children with congenital idiopathic talipes equino varus (club foot) foot deformity.

Children are ideally seen within four to six weeks of birth, and commence treatment with serial casting immediately. The treatment procedure requires weekly visits and full correction is often achieved within 10 to 12 weeks.

Patients in the Club Foot Program are usually seen by an orthopaedic surgeon and a physiotherapist. The physiotherapist will be responsible for the majority of non-surgical treatment and follow up care. An orthopaedic technologist will be involved in cast applications with the physiotherapist. Patients will visit an orthotist for fitting of the boot and bar brace when the maintenance phase of treatment is reached. Other staff may be included in your child's assessment if it is required.

Clubfoot Clinic for cast treatment using the Ponseti method runs weekly with collaboration between the orthopaedic surgeons and a specialty-trained physiotherapist practitioner.

Children are monitored in clinic for the first year, then biannually until approximately five years of age. For location and more see Physio Club Foot Clinic.

Scoliosis Clinic

The Scoliosis Clinic is a practitioner run clinic, with the support of the orthopaedic surgeons, focusing on the conservative management of scoliosis. This clinic, for non-operative management of spine deformity is run by a specialty-trained physiotherapist practitioner. Spinal curvatures between 20 degrees and 45 degrees are assessed and managed with monitoring or bracing. Larger curvatures are followed by the orthopaedic surgeons when considering surgery. Monitoring is appropriate for smaller curves in the growing child or when teenagers are nearing the end of growth. Bracing is used for a child who has growth remaining with curves that are between 25 degrees and 45 degrees. The braces are made at SickKids in Orthotics.

For location and more, see Scoliosis Clinic.

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Elephant artwork "Trunk to Tail" 
above, provided through 

Operation: ART

Courtesy of Canadian artist, 
Susanna Bleasby

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