How to Approach a Child
Orthopaedic problems in children require a different approach to that in adults. In general, children are scared during an examination and do not always understand why they need to visit the doctor. Moreover they find it difficult to describe complaints and sometimes indicate pain at a location completely different to where the abnormality is (not the same as referred pain).
Toys in the examination or consultation room make the room more child-friendly. Allow the child to get used to the situation by first talking with the parents and then gradually involve the child in the conversation. In the case of small children, approach the child both before and during the examination by making eye contact at their level or squat/kneel in front of the child.
There should be enough space to observe the child walking. If necessary, allow small children to sit on the parent’s knee. Almost all examinations can be performed in such a position. Experience has taught that many small children cry and struggle if placed on the examination table. If necessary, a baby can be distracted during the examination with the aid of a dummy or a bottle feed. For a toddler, a toy often provides sufficient distraction. Ensure that there is enough space if the gait pattern of the child needs to be examined.
In the following sections, only those examinations not mentioned in previous chapters, or those requiring a specific approach in the case of children are described in greater detail. We will only deal with examinations of the lower extremities here.