Insights on Treating Pediatric Trauma

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I'm Dr. Mitzi Williams, and I'm a pediatric foot and ankle surgeon who's been invited to speak at the National this year in Washington, DC.

What unique aspects of lower extremity trauma in the pediatric population should surgeons keep in mind?

You know, when looking at some of the unique characteristics or factors when treating the pediatric patients, specifically children undergoing various osseous traumas, things to keep in mind are number one, how much growth does that child have it play? And so children who have greater than three years of growth available, those children are more at risk of either limb-length discrepancies, so lack of growth, or two, angular deformities.

And so we're always thinking about, one, how do we minimize such from happening? But we do take a step back and recognize that many of these injuries themselves play a very, very big role into the aftermath. And so I encourage most people who treat children, you learn that you need to follow these children long term.

What emerging research should surgeons be aware of?

There's always emerging research, and I think pediatric research is always very challenging as well, especially with new products, as to getting good quality research. There's always ongoing research as to how do we improve the aftermath specifically on traumatic injuries and how are we executing such, specifically with the use of CT scans and minimizing, larger incisional approaches and using smaller incisional approaches to one protect the bone, protect growth plates or growth centers, and two, protect the soft tissue and minimize contractures that can form as a young person is growing. I think there's still ongoing beautiful research as well in the world of congenital deformities and also using some of these smaller or more less invasive approaches to minimize the deficit or trauma from a histopathology side when treating children as well.

The bottom line on pediatric trauma

You know, it's like everything that we treat. You know, with volume, you gain a certain level of expertise. And it's exactly the same in the world of pediatrics, as the more children you treat, the more comfortable you get with pathology, with procedural approaches, and really when to intervene and when to pull back. I always find from talking to people across the country, there's always a hesitancy in intervening and especially intervening from an invasive approach.

But quite frankly, you know, sometimes holding back and being very reserved is actually a deficit, you know, or doing harm in and of itself. And so seeing a great deal of volume, following children, learning when to intervene on certain pathologies, very helpful. And also, like everything that we treat, knowing when you need to ask a colleague or ask someone else for help or advice. You know, I found that to be ongoing mentorship, you know, a lifelong learning in medicine is extremely important. And peds is no different.