Our Services

Explore Our Pediatric Orthopedic Services

Fracture and Broken Bone Care

Evaluation, treatment, casting, and follow-up for fractures involving growing children and teens.

Sports Injuries

Care for acute and overuse injuries affecting young athletes across a wide range of sports and activities.

Congenital and Developmental Concerns

Evaluation of foot position, walking and mobility, limb alignment, hip development, spinal alignment, limb length, and other growth-related concerns.

In-House X-Rays and Casting

On-site imaging and pediatric-focused immobilization when medically appropriate, with follow-up as the child heals and grows.

Why Pediatric Orthopedic Care Is Different

A child’s skeleton is actively changing. Growth plates, also called physes, are areas of developing tissue near the ends of many long bones. They help determine the length and shape of the mature bone. Because these areas are not present in the same form after growth is complete, some childhood injuries require decisions that differ from those in adult orthopedic care.

Children’s bones can also bend or buckle in ways that are less common in adults. Greenstick fractures break only partway through the bone, while buckle fractures compress the bone without a complete break. Young bones often have strong healing and remodeling potential, but that does not mean every fracture can be ignored or treated in the same way. Bone alignment, the body part involved, the child’s age, and the amount of growth remaining all matter.

Development is equally important. A walking pattern typical at one age may warrant closer evaluation at another. Bowed legs, feet that turn inward or outward, uneven shoulders, or a difference in leg length may be part of normal development, but they can also reflect a condition that benefits from monitoring or treatment. A pediatric orthopedic evaluation helps separate normal variation from a problem that requires action.

Fracture and Broken Bone Care From Birth Through Age 19

Fracture care is the core of Cactus Pediatric Orthopaedics. A fracture is the medical term for a broken bone. Children may be injured during a fall, playground activity, sports, biking, skating, a vehicle crash, or ordinary play. Infants and young children may be unable to explain where they hurt, while older children may minimize pain because they want to return to an activity.

The ability to move an injured arm or leg does not rule out a fracture. Parents may notice swelling, bruising, tenderness in one location, pain with movement, refusal to use the limb, or an unusual shape. When a limb appears crooked, bone is visible, bleeding will not stop, or if circulation or sensation seems affected, emergency evaluation is more appropriate than waiting for an office appointment.

Common Pediatric Fracture Patterns

The appearance and treatment of a fracture depend on how the bone was injured. A buckle or torus fracture occurs when the bone compresses and bulges. A greenstick fracture affects one side of the bone, similar to a young branch that bends and partly breaks. A complete fracture extends through the bone. Other fractures may be displaced, meaning the broken ends are no longer properly aligned.

Some injuries extend into a joint or involve a growth plate. These details can affect treatment and follow-up. Growth plate injuries deserve particular attention because the plate contributes to future bone growth. A child may need monitoring even after pain improves and the fracture appears healed, depending on the location and severity of the injury.

How Fractures Are Evaluated

The appointment begins with questions about how the injury happened, when symptoms began, and what treatment the child has already received. The provider examines the area for tenderness, swelling, alignment, range of motion, stability, skin integrity, and circulation. If the child has already visited an emergency department or urgent care center, the family should bring any XRs or other imaging with them.

X-rays are commonly used to evaluate a suspected fracture. Images can show the location and pattern of a break, alignment, and whether a joint or growth plate may be involved. Not every injury is immediately obvious on an X-ray, and additional imaging or repeat evaluation may sometimes be recommended based on the child’s symptoms and examination.

Pediatric Fracture Treatment

Many fractures can be treated without surgery. A splint, cast, brace, or other form of immobilization may protect the bone while it heals. If the broken pieces are misaligned, the provider may recommend a reduction to improve their position. Some fractures require a procedure or surgery because of displacement, instability, joint involvement, an open wound, or concern about future growth and function.

The treatment decision is individualized. Two children with injuries to the same bone may receive different recommendations because of their ages, fracture patterns, alignment, symptoms, and remaining growth. Parents should understand why a particular option is recommended, how long immobilization may be needed, and what warning signs require a call.

Follow-Up During Healing

Follow-up helps the provider evaluate comfort, cast fit, fracture alignment, and healing. Additional X-rays may be recommended at specific stages. The family may also receive instructions about school, bathing, sleep, activity, and the safe use of slings or crutches.

Healing time varies. A child should not return to sports simply because pain is gone or the cast has been removed. The bone and surrounding tissues may need more time before they can safely tolerate contact, falls, throwing, running, or other sport-specific stress. The provider will consider the diagnosis, healing, strength, motion, and risk of reinjury before clearing activities.

Pediatric Sports Injury Care for Young Athletes

Children and teens participate in school sports, club teams, recreation leagues, dance, gymnastics, martial arts, swimming, running, biking, and many other physical activities throughout Gilbert and the East Valley. Movement supports health and development, but growing athletes can experience both sudden injuries and problems caused by repeated stress.

An acute injury happens during a specific event, such as a fall, collision, awkward landing, twist, or direct blow. An overuse injury develops when repeated activity places more stress on a bone, growth area, tendon, muscle, or joint than the body can recover from between sessions. Symptoms may begin as mild soreness and become more persistent over time.

Signs That a Sports Injury Needs Evaluation

Parents and coaches should pay attention when pain changes the way a child moves or participates. A young athlete may limp, avoid using one arm, lose range of motion, report swelling or instability, or struggle with activities that were previously comfortable. Pain that returns with every practice, wakes the child, persists during rest, or causes declining performance deserves attention.

The pressure to stay on the field can make children hide symptoms. Continuing to train through pain may worsen some injuries or delay healing. Evaluation can help determine whether the problem is a minor irritation, a fracture, a ligament or tendon injury, a growth-related condition, or an overuse problem that requires a change in training.

Acute Sports Injuries

Sudden injuries may include fractures, dislocations, sprains, ligament, meniscus, or tendon injuries, and cartilage damage. The first priority is determining severity. A child with an obvious deformity, severe swelling, inability to bear weight after major trauma, loss of sensation, or signs of poor circulation needs urgent or emergency care.

Overuse and Throwing Injuries

Overuse injuries may affect runners, gymnasts, dancers, swimmers, baseball and softball players, tennis players, and athletes who train frequently in a single movement pattern. Stress fractures, little league elbow, Osgood Schlatter disease, and certain shoulder or knee problems can develop gradually.

Returning to Sports Safely

Return-to-play decisions are based on more than a calendar date. The athlete may need adequate healing, pain-free range of motion, strength, balance, stability, endurance, and the ability to perform sport-specific movements. A child recovering from a throwing injury faces different demands than a soccer player returning after an ankle injury.

Returning too early can increase the risk of reinjury or lead to compensations that stress another part of the body. A staged progression allows the child to increase activity while watching for pain, swelling, weakness, or altered movement. Parents should follow the individualized restrictions and clearance provided for their child.

Congenital and Developmental Orthopedic Concerns

Not every orthopedic visit begins with an accident. Parents may notice a baby’s hip or leg position, a toddler’s walking pattern, a child’s bowed legs, uneven shoulders, a change in posture, or a difference in limb length. Some variations are expected during growth. Others require observation, imaging, or treatment.

The purpose of an evaluation is not to label every difference as abnormal. It is to understand whether the finding fits the child’s age and development, whether it is changing, and whether it affects comfort, balance, mobility, or function.

Foot, Walking, Gait, and Mobility Concerns

Gait is the way a person walks. Children develop walking skills over time, and early movement can look different from mature walking. Parents may notice intoeing, out-toeing, frequent tripping, toe walking, limping, uneven wear on shoes, or difficulty keeping up with peers.

An orthopedic evaluation may include observing the child stand, walk, and run. The provider may examine hip rotation, knee alignment, leg length, foot position, joint motion, muscle strength, and neurologic signs. The medical and family history can also be important because some alignment patterns run in families.

Many gait variations improve as a child grows. When treatment is needed, it depends on the cause. Monitoring, stretching, therapy, bracing, additional testing, or surgery may be considered in selected cases. Generic shoe inserts or braces should not be assumed to correct every walking pattern.

Bowed Legs and Limb Alignment

Bowed legs describe a shape in which the knees remain apart when the ankles are together. Some bowing is common in babies and young toddlers and changes naturally with growth. The timing, severity, symmetry, and progression help determine whether the pattern is typical.

Evaluation may be appropriate when bowing is severe, affects one side more than the other, worsens rather than improves, causes pain or difficulty walking, or occurs outside the expected developmental pattern. The provider may measure alignment and decide whether X-rays or follow-up over time are needed.

Hip Dysplasia and Hip Dislocation in Babies

Developmental dysplasia of the hip, often called DDH, occurs when the ball at the top of the thighbone does not fit securely in the hip socket. The hip may be loose, partly out of the socket, or completely dislocated. Early identification matters because treatment options and outcomes can depend on the child’s age and severity of the condition.

Parents may be referred after an abnormal newborn examination, an imaging result, or concern about hip motion, leg position, or asymmetry. Babies do not always show obvious symptoms. Evaluation may include a physical examination and age-appropriate imaging. Treatment can range from monitoring to bracing, casting, or surgery.

Scoliosis and Spinal Alignment

Scoliosis is a sideways curvature of the spine that may become more noticeable during growth. Parents, pediatricians, or school screenings may identify uneven shoulders, a prominent shoulder blade, an uneven waist, or one side of the rib cage appearing higher during a forward bend.

An evaluation considers the child’s age, symptoms, physical examination, curve pattern, and remaining growth. X-rays may be used to measure the curve. Some children need observation only, while others may need bracing or surgical evaluation. The plan depends on the type and size of the curve, as well as the likelihood that it will progress.

Back pain does not automatically mean scoliosis, and many children with scoliosis do not have pain. New weakness, numbness, loss of bowel or bladder control, or severe symptoms after trauma require urgent medical attention.

Limb Length Differences

One arm or leg may be shorter than the other because of normal variation, a prior injury, a growth plate problem, a congenital condition, or another medical cause. A small difference may not affect function. A larger or changing difference may influence walking, posture, balance, or joint stress.

The provider may use measurements, standing examination, gait observation, and imaging to estimate the difference and the child’s remaining growth. Treatment may involve observation, a shoe lift, growth-guided procedures, or other surgery in selected cases. Timing matters because the plan may depend on how much growth remains.

Growth Plate Concerns

Growth plates are vulnerable to injury because they are developing areas of the skeleton. A growth plate can be affected by a fracture, repeated stress, infection, or another condition. Most growth plate injuries heal without lasting problems when properly treated, but certain injuries can contribute to growth arrest, angulation, or a difference in limb length.

The need for follow-up depends on the specific injury. In some cases, changes are not visible immediately. The provider may recommend later examinations or imaging to confirm that growth continues as expected.

In-House X-Rays and Pediatric Casting

Orthopedic care often depends on seeing how bones and joints are aligned. Cactus Pediatric Orthopaedics offers in-house X-rays when medically appropriate. On-site imaging can help families avoid arranging a separate appointment at a radiology center and can allow the provider to consider the images alongside the child’s history and examination.

What X-Rays Can Show

X-rays create images of dense structures such as bone. They may help identify fractures, alignment changes, joint relationships, spinal curvature, limb length differences, and certain developmental conditions. The number and position of images depend on the body part and clinical question.

An X-ray is not the answer to every orthopedic problem. Soft tissues such as ligaments, tendons, cartilage, and muscles may require additional imaging when the diagnosis remains unclear. Some early stress injuries or subtle fractures may also require follow-up. The provider decides whether X-rays, additional testing, or outside imaging are appropriate.

Casting and Immobilization

A cast holds an injured area in a protected position while tissue heals. Different materials, lengths, and designs are used for different injuries. Some children begin in a splint to allow room for early swelling, then transition to a cast. Other injuries may be treated with a removable brace.

The provider determines the type of immobilization, how long it should remain in place, and whether weight bearing or joint movement is allowed. Families receive instructions on keeping the cast protected and monitoring the child’s fingers or toes for any changes.

Cast Care and Warning Signs

Unless the family receives instructions that a particular cast is water-safe, the cast should be kept dry. Children should not insert objects, powders, or lotions inside it. A damaged, wet, soft, or very loose cast may not properly protect the injury.

Contact the office promptly for increasing pain, numbness, tingling, burning, a feeling that the cast is too tight, or fingers or toes that become pale, blue, cold, or difficult to move. A bad odor, drainage, fever, skin irritation at the edge, or an object stuck inside the cast also deserves attention. Severe symptoms or signs of compromised circulation require urgent evaluation.

Cast Removal and the Next Stage of Recovery

After a cast is removed, the skin may be dry, and the limb may look smaller or feel stiff. Temporary weakness and limited motion are common after immobilization. Parents should follow instructions for bathing, skin care, exercise, therapy, and activities.

Children should not assume they can return immediately to playgrounds, trampolines, contact sports, or high-risk activity. The provider may recommend a gradual progression while bone strength, motion, and confidence return.

When to Schedule and When to Seek Emergency Care

An office appointment may be appropriate for a confirmed fracture needing follow-up, ongoing pain, a sports injury that is not improving, a repeated sprain, a limp, changes in walking, concerns about limb alignment, uneven shoulders, hip development, or a possible difference in limb length.

Emergency care is more appropriate for major trauma, uncontrolled bleeding, bone protruding through the skin, an obviously deformed limb, loss of consciousness, severe neck or back injury, or a hand or foot that becomes pale, blue, cold, numb, or difficult to move. Call 911 when emergency transportation is needed.

This page provides general information. It cannot determine the seriousness of a specific child’s symptoms or replace individualized medical advice.

Pediatric Orthopedic Care for Gilbert and the East Valley

Cactus Pediatric Orthopaedics serves families from Gilbert and surrounding East Valley communities, including Chandler, Mesa, Queen Creek, San Tan Valley, Tempe, and Apache Junction. The office is at 3420 S. Mercy Road, Suite 107, on the Mercy Gilbert campus near South Val Vista Drive and the Loop 202.

The practice works with pediatricians, family physicians, emergency departments, and urgent care centers across the Valley. When a child receives initial care elsewhere, families should bring any records, imaging, and discharge instructions to the office with them for their orthopedic appointment.

Frequently Asked Questions