Pediatrics is a unique specialty within the realm of orthopaedics and musculoskeletal medicine. Unlike those physicians who focus on one region of the body or one type of disease, pediatric musculoskeletal specialists are given the opportunity to care for the whole patient (head to toe, quite literally) across many types of pathology, including trauma, tumor, and congenital conditions.
The pediatric musculoskeletal specialist is also afforded the chance to develop a relationship with patients and their families, watching patients mature and grow.
Pediatric musculoskeletal medicine offers treatments that can (almost) cure. Relocating a dislocated hip in the neonate may allow a fairly normal hip joint to develop; a forearm fracture sustained at age 6 might have no residual consequence in the adult at all. (No knock on my adult-focused colleagues, but a knee joint with a reconstructed cruciate ligament is not a normal knee joint, and a total knee replacement is not a “knee” joint at all.)
Of course, on the other hand, the pediatric musculoskeletal specialist also takes care of some diseases that are, if not progressive, irreversible. (The six chapters in the section “Musculoskeletal Aspects of Pediatric Syndromes” provide plenty of examples.) Yet in those cases too, the physician can make a big difference, substantially improving the patients’ quality of life.
This book – a collaborative effort by more than fifty leading physicians and researchers from dozens of children’s hospitals, healthcare systems and medical schools – was conceived as a tool for students, a tool that will help them improve their future patients’ quality of life. Its aim is to contribute toward a foundation of knowledge that will allow physicians to make a positive impact.
I decided to practice pediatric orthopaedics for that very reason: to engage in work that has the potential for positive, lifelong impact on not only patients, but on their families as well. I try to live up to the standard articulated by Nelson Mandela: “History will judge us by the difference we make in the everyday lives of children.” I consider it the ultimate privilege to care for a child. It is my hope this text helps others acquire the tools that will let them have a similar positive impact as well.
Jason B. Anari, MD
Children's Hospital of Philadelphia