Metatarsus Adductus Vs Clubfoot: Key Differences
Metatarsus Adductus Vs Clubfoot: Key Differences When it comes to foot deformities in children, two commonly encountered conditions are Metatarsus Adductus and Clubfoot. These congenital abnormalities require specialized care from the field of pediatric orthopedics. Understanding the differences between Metatarsus Adductus and Clubfoot is crucial for accurate diagnosis and appropriate treatment.
Understanding Metatarsus Adductus
Metatarsus Adductus is a common congenital foot condition characterized by the inward bending of the forefoot. Also known as metatarsus varus, this foot deformity can affect one or both feet and typically presents at birth. Understanding the causes and symptoms of Metatarsus Adductus is crucial in its diagnosis and treatment.
Causes: Metatarsus Adductus is believed to be caused by intrauterine positioning of the fetus, specifically the positioning of the foot during development. This can lead to the abnormal development of foot bones and muscles, resulting in the characteristic inward curvature of the forefoot.
Symptoms: The symptoms of Metatarsus Adductus can vary depending on the severity of the deformity. Common signs include:
- An inwardly curved forefoot
- Tightness or stiffness in the foot
- Difficulty straightening the foot
- Toe-pointing towards the midline of the foot
Diagnosing Metatarsus Adductus involves a thorough orthopedic assessment and close examination of the foot structure. This typically includes:
- Physical examination: An orthopedic specialist will assess the foot alignment, range of motion, and muscle tone.
- X-rays: Imaging studies may be conducted to evaluate the bone structure and rule out any other underlying foot conditions.
By accurately diagnosing Metatarsus Adductus, healthcare professionals can determine the appropriate treatment plan to correct the foot deformity and promote optimal foot development.
Metatarsus Adductus | Clubfoot |
---|---|
An inward bending of the forefoot | A fixed and rigid inward twisting of the foot and ankle |
Treatment involves non-surgical interventions such as stretching exercises and orthotic devices | Requires a multi-step treatment approach, often involving casting, stretching, and possibly surgery |
Early detection and intervention can lead to successful correction without surgical intervention | Early intervention is crucial, and treatment often involves the Ponseti method to gradually reposition the foot |
Diagnosing Metatarsus Adductus
Metatarsus Adductus Vs Clubfoot: Key Differences In order to diagnose Metatarsus Adductus, medical professionals rely on specific criteria and perform orthopedic assessments to accurately identify this foot deformity. These diagnosis methods help determine the severity of the condition and guide appropriate treatment options.
Diagnosis Criteria:
- Misalignment of the foot: The foot appears to turn inward, with the forefoot deviating towards the midline.
- Angle of deviation: The angle between the first metatarsal (long bone of the foot) and the midline of the foot is measured to assess the severity of the deformity.
- Flexible or rigid deformity: The flexibility of the foot in relation to the metatarsus adductus is assessed to determine the treatment approach.
- Presence of other associated foot deformities or conditions: Additional foot abnormalities or related conditions may be present and require evaluation.
Orthopedic Assessment:
To confirm the diagnosis, orthopedic assessments are performed by medical professionals, which may include:
Orthopedic Assessment Techniques | Explanation |
---|---|
Physical examination | A thorough assessment of the foot, evaluating its range of motion, flexibility, and alignment. |
Gait analysis | Observation of how a person walks to identify any abnormalities in their gait pattern caused by metatarsus adductus. |
Imaging studies | X-rays or ultrasound may be utilized to visualize the bones and soft tissues of the foot, providing a more detailed assessment of the deformity. |
By utilizing the diagnosis criteria and conducting orthopedic assessments, healthcare professionals can accurately diagnose Metatarsus Adductus and determine the most appropriate treatment plan for each individual case.
Treatment Options for Metatarsus Adductus
Metatarsus Adductus Vs Clubfoot: Key Differences When it comes to managing Metatarsus Adductus, there are various treatment options available. The primary goal of treatment is to correct the foot alignment and improve function. Non-surgical interventions are often the first line of treatment, focusing on stretching exercises, orthotic devices, and footwear modifications.
Stretching Exercises
Stretching exercises play a crucial role in the treatment of Metatarsus Adductus. These exercises aim to stretch the tight ligaments and muscles on the inside of the foot, gradually correcting the adducted position. Parents or caregivers are usually taught how to perform these exercises at home on a regular basis.
Orthotic Devices
Orthotic devices, such as braces or splints, are commonly used in the treatment of Metatarsus Adductus. These devices help maintain the correct foot alignment and provide support for the foot arch. They are usually worn for a specific period, depending on the severity of the condition and the child’s response to treatment.
Footwear Modifications
In some cases, footwear modifications can be beneficial in correcting the foot alignment in Metatarsus Adductus. This may involve using specially designed shoes or inserts that provide additional support and help realign the foot. The selection of appropriate footwear is crucial, and it is recommended to consult a healthcare professional or orthopedic specialist for guidance.
In certain instances when non-surgical interventions are unsuccessful or the condition is severe, surgical treatment may be considered. However, surgical intervention is usually reserved for rare cases and is not typically the first choice for managing Metatarsus Adductus. Pediatric orthopedic specialists are best equipped to determine the most appropriate treatment options based on the individual needs of each patient.
Treatment Options | Description |
---|---|
Stretching Exercises | Regularly performed by parents or caregivers to stretch the tight ligaments and muscles of the foot, gradually correcting the adducted position. |
Orthotic Devices | Braces or splints are used to maintain correct foot alignment and provide support to the foot arch. The duration of usage depends on the severity and response to treatment. |
Footwear Modifications | Specially designed shoes or inserts can be used to realign the foot and provide additional support. Expert guidance is recommended for appropriate footwear selection. |
Clubfoot: An Overview
Clubfoot is a common congenital foot deformity that affects approximately 1 in every 1,000 births worldwide. It is characterized by an inward and downward rotation of the foot, causing it to appear twisted or inverted. This condition can impact one or both feet and may vary in severity.
Clubfoot is often present at birth and can be detected during routine physical examinations of newborns. While the exact cause of clubfoot is not fully understood, research suggests that both genetic and environmental factors may play a role in its development.
Some of the common symptoms of clubfoot include:
- Inward rotation of the foot
- Inward pointing of the toes
- Smaller calf muscles on the affected side
- Tightness or stiffness in the foot and ankle
Without proper treatment, clubfoot can lead to long-term complications such as difficulty walking, foot pain, and instability. However, with early intervention, most cases can be successfully treated, allowing children to lead active and pain-free lives.
Treatment for clubfoot typically involves a combination of nonsurgical and surgical approaches. The Ponseti method, a widely used nonsurgical technique, involves gentle manipulation and stretching of the foot, followed by the application of a cast to hold the foot in the corrected position. This process is repeated over several weeks to gradually realign the foot.
For cases that do not respond to nonsurgical treatment or for individuals who start treatment at a later age, surgery may be recommended. Surgical techniques aim to release tight ligaments and tendons, reconstruct the foot’s anatomy, and promote proper alignment and function.
It is important to note that early diagnosis and intervention are crucial for the successful management of clubfoot. Seeking care from a pediatric orthopedic specialist experienced in treating foot deformities is essential for ensuring the best outcomes for children with clubfoot.
How Clubfoot is Diagnosed
Metatarsus Adductus Vs Clubfoot: Key Differences In order to diagnose Clubfoot, healthcare professionals utilize a combination of diagnostic criteria, orthopedic assessments, imaging studies, and prenatal screenings. By carefully evaluating these factors, they are able to accurately identify this congenital foot deformity.
The diagnosis of Clubfoot involves a comprehensive examination and analysis of the foot structure. The criteria used to diagnose Clubfoot typically include:
- Foot appearance: The foot may exhibit significant internal rotation or inversion of the forefoot, with the heel in a plantar-flexed position.
- Limited range of motion: Clubfoot often presents with restricted movement of the affected foot joints.
- Muscular abnormalities: Muscles on the affected side of the foot may be underdeveloped or weak.
In addition to the clinical assessment, orthopedic specialists may employ various diagnostic techniques and imaging studies to confirm the diagnosis of Clubfoot. These may include:
- Ultrasound: Ultrasound imaging can be performed during pregnancy to detect Clubfoot in the fetus. It allows for early intervention and appropriate planning.
- X-ray: X-rays can provide detailed images of the bones and joints in the foot, aiding in the assessment of skeletal abnormalities associated with Clubfoot.
Prenatal screenings may also play a role in diagnosing Clubfoot. During routine prenatal ultrasound examinations, healthcare professionals may detect the presence of abnormal foot positioning, which could be indicative of Clubfoot.
By utilizing a combination of these diagnostic methods, medical professionals can accurately diagnose Clubfoot and develop an appropriate treatment plan tailored to the individual characteristics and needs of the patient.
Diagnostic Criteria for Clubfoot | Diagnostic Techniques |
---|---|
Foot appearance: internal rotation or inversion of the forefoot, plantar-flexed heel | Ultrasound |
Limited range of motion in foot joints | X-ray |
Muscular abnormalities |
Treatment Approaches for Clubfoot
Clubfoot is a congenital foot deformity that affects the alignment of the foot and ankle. Fortunately, there are several treatment options available to manage this condition. The choice of treatment depends on various factors, including the severity of the deformity and the child’s age.
Non-Surgical Methods
Metatarsus Adductus Vs Clubfoot: Key Differences Non-surgical approaches are often the first line of treatment for clubfoot. One widely used method is the Ponseti method, which involves gentle manipulation and casting of the foot to gradually improve its alignment. This technique has shown excellent results in correcting clubfoot in infants and young children.
Orthotic devices, such as foot abduction braces, are commonly used alongside the Ponseti method to maintain the corrected position of the foot. These braces help to prevent relapse and promote proper development of the foot over time.
Surgical Interventions
In some cases, surgical intervention may be necessary to correct severe or resistant clubfoot deformities. Surgical procedures aim to release tight ligaments and tendons, reposition bones, and improve the overall alignment of the foot.
Metatarsus Adductus Vs Clubfoot: Key Differences One common surgical technique is the Achilles tenotomy, which involves cutting the Achilles tendon to increase ankle flexibility. This procedure is often performed in combination with other surgical interventions to optimize the correction of the clubfoot deformity.
It is important to note that surgical interventions are typically used as a last resort when non-surgical options have not produced satisfactory results.
Treatment Comparison
Here is a comparison of the non-surgical and surgical treatment approaches for clubfoot:
Treatment Approach | Description |
---|---|
Non-Surgical Approach (Ponseti method) |
– Gentle manipulation and casting – Gradual correction of foot alignment – Use of orthotic devices to maintain correction – High success rate |
Surgical Interventions |
– Release of tight ligaments and tendons – Repositioning of bones – Achilles tenotomy to increase ankle flexibility – Reserved for severe or resistant cases |
It is essential to consult with a qualified pediatric orthopedic specialist to determine the most suitable treatment approach for a child with clubfoot. Early intervention and consistent follow-up are key to achieving the best outcomes in managing this condition.
Differences Between Metatarsus Adductus and Clubfoot
Metatarsus adductus and clubfoot are both congenital foot conditions that can affect the alignment and development of a child’s feet. While they may seem similar, there are important differences between the two. Understanding these differences is crucial in ensuring accurate diagnosis and appropriate treatment. Let’s explore the contrasts between metatarsus adductus and clubfoot:
Etiology:
Metatarsus adductus: This condition occurs when the metatarsal bones, which are the long bones in the foot, are abnormally positioned inwards towards the midline of the foot. The exact cause of metatarsus adductus is unknown, but it is believed to be related to factors such as intrauterine positioning and genetics.
Clubfoot: Clubfoot is a more complex condition characterized by a combination of foot abnormalities, including the foot being twisted inward and downward. The precise cause of clubfoot is still unclear, but it is thought to be influenced by genetic and environmental factors.
Clinical Presentation:
Metatarsus adductus: In infants with metatarsus adductus, the shape of the foot appears curved or banana-shaped, with the forefoot turning inward. The condition is often flexible, meaning that the foot can be straightened to some degree manually or with gentle stretching exercises.
Clubfoot: Clubfoot is characterized by a more rigid and severe deformity. The foot is turned inward, and the Achilles tendon is tight, causing the foot to be difficult or impossible to correct manually. The affected foot may also be shorter and smaller than the unaffected foot.
Treatment Strategies:
Metatarsus adductus: Non-surgical interventions are usually the primary approach for treating metatarsus adductus. Mild cases may resolve on their own over time, with regular stretching exercises and the use of special footwear or orthotic devices to promote proper alignment and development of the foot.
Clubfoot: Treatment for clubfoot typically involves a combination of nonsurgical and surgical methods. The Ponseti method, which involves a series of gentle manipulations and casting, is often used initially to gradually correct the foot deformity. In some cases, surgical intervention may be required to release tight tendons and align the foot properly.
Metatarsus Adductus | Clubfoot |
---|---|
Metatarsal bones positioned inwards towards the midline of the foot | Twisted inward and downward foot, accompanied by additional deformities |
Flexible deformity, can be manually straightened or corrected with stretching exercises | Rigid deformity, difficult or impossible to correct manually |
Non-surgical interventions like stretching exercises and special footwear | Ponseti method, surgical intervention if necessary |
When to Seek Pediatric Orthopedic Care
Metatarsus Adductus Vs Clubfoot: Key Differences For parents and caregivers dealing with congenital foot conditions such as Metatarsus Adductus and Clubfoot, seeking pediatric orthopedic care is crucial. Pediatric orthopedic specialists are trained in diagnosing and managing foot deformities in children, ensuring the best possible outcomes for their patients.
Early identification and intervention are key factors in the successful treatment of congenital foot conditions. By consulting with a pediatric orthopedic expert, parents can have peace of mind knowing that their child’s condition will be accurately diagnosed and appropriate treatment options will be explored.
The expertise of pediatric orthopedic specialists extends beyond diagnosis and treatment. These medical professionals understand the unique challenges that foot deformities can present in a child’s development and mobility. They take a holistic approach to care, considering the long-term implications of the condition and tailoring treatment plans accordingly.
Benefits of Seeking Pediatric Orthopedic Care:
- Accurate diagnosis of congenital foot conditions
- Specialized knowledge and expertise in pediatric orthopedics
- Comprehensive treatment options tailored to the child’s needs
- Early intervention to optimize long-term outcomes
- Ongoing monitoring and support throughout the treatment process
By choosing pediatric orthopedic care for their child’s foot deformities, parents can ensure that they are receiving the highest level of medical care and support. Treating these conditions early on can help alleviate symptoms, correct foot alignment, and improve overall function.
Reasons to Choose Pediatric Orthopedic Care: | Reasons to Choose Pediatric Orthopedic Care: |
---|---|
Accurate diagnosis of congenital foot conditions | Specialized knowledge and expertise in pediatric orthopedics |
Comprehensive treatment options tailored to the child’s needs | Early intervention to optimize long-term outcomes |
Ongoing monitoring and support throughout the treatment process | Improved quality of life for the child |
Seeking pediatric orthopedic care is an investment in your child’s future. By partnering with experts in the field, you can ensure that your child receives the best possible care for their congenital foot condition.
Importance of Early Intervention
Early intervention plays a crucial role in the effective treatment of foot deformities, such as Metatarsus Adductus and Clubfoot. By addressing these conditions at their earliest stages, pediatric orthopedic specialists can significantly improve the long-term outcome for children.
Foot deformities, including Metatarsus Adductus and Clubfoot, can affect the development and function of a child’s feet if left untreated. However, early diagnosis and appropriate treatment interventions can help correct these deformities, allowing children to lead active, healthy lives.
Through pediatric orthopedics, healthcare professionals can identify foot deformities in infants and provide tailored treatment plans to address each child’s specific needs. This early intervention not only helps correct the alignment of the feet but also prevents the progression of the conditions, reducing the risk of long-term complications.
Early intervention offers a range of benefits, from improving the child’s ability to walk and engage in physical activities to enhancing overall foot function and aesthetics. It also minimizes the need for more invasive treatments, such as surgeries, as non-surgical interventions are often effective in correcting foot deformities when initiated early.
Key Benefits of Early Intervention:
- Promotes proper foot development: Early treatment helps guide the growth and alignment of the feet, allowing for better walking mechanics and preventing gait abnormalities.
- Minimizes the need for surgical interventions: Early intervention with non-surgical methods significantly reduces the necessity for invasive surgeries.
- Improves mobility and functionality: Timely treatment allows children to have better control over their foot movements and encourages them to participate in physical activities.
- Enhances overall quality of life: Correcting foot deformities early on contributes to a child’s overall well-being by preventing pain and discomfort associated with untreated conditions.
Metatarsus Adductus Vs Clubfoot: Key Differences By emphasizing the importance of early intervention in managing foot deformities, parents and caregivers can ensure that their children receive prompt medical attention from pediatric orthopedic specialists. Collaborating with healthcare professionals experienced in pediatric orthopedics enables them to provide the most appropriate and effective interventions tailored to their child’s unique needs, ultimately leading to optimal outcomes.
Key Takeaways |
---|
Early intervention plays a critical role in treating foot deformities like Metatarsus Adductus and Clubfoot. |
Timely treatment improves foot development, mobility, and functionality. |
Early intervention minimizes the need for surgical interventions. |
Collaborating with pediatric orthopedic specialists ensures appropriate and effective treatment plans. |
Holistic Approach to Congenital Foot Deformities
When it comes to treating congenital foot deformities like metatarsus adductus and clubfoot, pediatric orthopedic specialists take a holistic approach. By considering the unique needs and development stages of each individual child, these experts employ a range of non-surgical interventions that prioritize proper foot alignment and support.
Non-surgical interventions play a crucial role in managing foot deformities in children. These treatment options focus on correcting and supporting the natural development of the affected feet, without the need for invasive procedures. By utilizing non-surgical interventions, pediatric orthopedic specialists aim to improve foot function and reduce the risk of long-term complications associated with these conditions.
The following non-surgical interventions are commonly employed:
- Physical Therapy: Customized physical therapy programs are designed to improve muscle strength, joint flexibility, and overall mobility. Through targeted exercises and stretches, physical therapy helps correct foot alignment and promote optimal foot function.
- Orthotic Devices: Orthotic devices, such as braces, splints, or shoe inserts, are used to support and reposition the foot. These devices are customized to fit the unique needs of the child and aid in correcting foot deformities.
- Footwear Modifications: Properly fitting shoes with specific modifications, such as added arch support or corrective splints, can help support proper foot alignment and aid in the correction of deformities.
- Casting: In some cases, casting is utilized to gradually stretch and reposition the foot into the correct alignment. This technique, often known as the Ponseti method, is particularly effective for the treatment of clubfoot deformities.
The combination of these non-surgical interventions allows pediatric orthopedic specialists to take a comprehensive approach to managing congenital foot deformities. By focusing on functionality, alignment, and development, these interventions aim to give children the best possible outcome in terms of foot health and mobility.
Treatment Options | Description |
---|---|
Physical Therapy | Customized exercises and stretches to improve muscle strength, joint flexibility, and overall mobility. Helps correct foot alignment and promote optimal foot function. |
Orthotic Devices | Customized braces, splints, or shoe inserts that support and reposition the foot to correct deformities and aid in proper alignment. |
Footwear Modifications | Modifications to shoes, such as added arch support or corrective splints, to support proper foot alignment and aid in deformity correction. |
Casting (Ponseti method) | Gradually stretching and repositioning the foot using casts to correct clubfoot deformities and promote proper alignment. |
Choosing a Healthcare Provider
When it comes to ensuring the best care for your child’s foot deformities, selecting the right healthcare provider is crucial. Acıbadem Healthcare Group, a renowned name in pediatric orthopedics, offers expertise and experience in diagnosing and treating conditions such as Metatarsus Adductus and Clubfoot.
Metatarsus Adductus Vs Clubfoot: Key Differences With a team of highly skilled specialists, Acıbadem Healthcare Group prioritizes delivering comprehensive care to children with foot deformities. Their pediatric orthopedic experts understand the unique challenges associated with these conditions and provide tailored treatment plans that address each child’s specific needs.
By choosing Acıbadem Healthcare Group, you can have confidence in their commitment to delivering top-quality care. Their multidisciplinary approach combines the latest advancements in medical technology with a compassionate and nurturing environment, ensuring the best possible outcomes for young patients with congenital foot conditions.
FAQ
What is the difference between Metatarsus Adductus and Clubfoot?
Metatarsus Adductus and Clubfoot are both foot deformities, but they have different characteristics. Metatarsus Adductus involves the curvature of the front part of the foot, causing the toes to point inward. In contrast, Clubfoot is a more severe deformity that affects the entire foot, causing it to turn inward and downward. The treatment approaches for these conditions also differ, with Metatarsus Adductus often managed through non-surgical interventions, while Clubfoot may require surgical intervention.
What are the causes of Metatarsus Adductus?
The exact cause of Metatarsus Adductus is unknown. However, it is believed to be a result of abnormal positioning in the womb or a problem with the development of the foot muscles and ligaments. It can also be associated with other medical conditions, such as hip dysplasia or torticollis.
What are the symptoms of Metatarsus Adductus?
The common symptoms of Metatarsus Adductus include the inward pointing of the toes, a curved or C-shaped foot shape, and limited foot flexibility. Some babies may also have tightness in the calf muscles or difficulty wearing certain types of footwear due to the shape of their feet.
How is Metatarsus Adductus diagnosed?
Metatarsus Adductus is typically diagnosed through a physical examination and orthopedic assessment. The doctor will assess the foot's flexibility, range of motion, and alignment. Imaging studies, such as X-rays or ultrasounds, may also be used to confirm the diagnosis and rule out other underlying conditions.
What are the treatment options for Metatarsus Adductus?
Non-surgical interventions are often the first line of treatment for Metatarsus Adductus. These may include stretching exercises, massage, and the use of orthotic devices, such as shoe inserts or braces, to help correct the foot alignment. In severe cases, casting or splinting may be necessary. In rare instances where non-surgical interventions are ineffective, surgery may be considered.
What are the causes of Clubfoot?
The exact cause of Clubfoot is unknown, but it is believed to be a combination of genetic and environmental factors. It can sometimes be seen in families or occur alongside other medical conditions. It is not caused by the positioning of the baby in the womb or by anything the parents did during pregnancy.
What are the symptoms of Clubfoot?
Clubfoot is characterized by the inward and downward turning of the foot. The foot may appear twisted and shorter than usual, with the heel turned inward. In severe cases, the affected foot may be rigid and stiff. Clubfoot can affect one or both feet.
How is Clubfoot diagnosed?
Clubfoot is typically diagnosed through a physical examination and orthopedic assessment. The doctor will assess the foot's alignment, range of motion, and flexibility. Imaging studies, such as X-rays or ultrasounds, may also be used to confirm the diagnosis and evaluate the severity of the deformity.
How is Clubfoot treated?
The treatment of Clubfoot typically involves a method known as the Ponseti method, which employs gentle stretching, casting, and bracing to gradually correct the foot's position. This non-surgical approach has proven to be highly effective in most cases. In rare instances where non-surgical interventions are unsuccessful, surgical correction may be considered.
What are the differences between Metatarsus Adductus and Clubfoot?
The key differences between Metatarsus Adductus and Clubfoot lie in the extent and severity of the deformity. Metatarsus Adductus primarily affects the front part of the foot, causing the toes to point inward, whereas Clubfoot affects the entire foot, causing it to turn inward and downward. The treatment approaches also differ, with Metatarsus Adductus often managed through non-surgical interventions and Clubfoot potentially requiring surgical intervention.
When should I seek pediatric orthopedic care for my child's foot deformity?
It is recommended to seek pediatric orthopedic care if you suspect that your child has a foot deformity. It is especially important to consult with a pediatric orthopedic specialist if the condition is affecting your child's daily activities, causing pain or discomfort, or if there are concerns about the foot's alignment or function.
Why is early intervention important for foot deformities?
Early intervention is crucial for foot deformities because it allows for prompt diagnosis and treatment. Starting treatment early can help minimize the severity of the deformity, improve foot function and alignment, and enhance the child's overall quality of life. Early intervention also provides the opportunity for non-surgical interventions to be effective, reducing the likelihood of needing surgical intervention later on.
What is the holistic approach to managing congenital foot deformities?
The holistic approach to managing congenital foot deformities emphasizes a comprehensive and multidisciplinary approach. It involves close collaboration between pediatric orthopedic specialists, physical therapists, and other healthcare professionals to provide a range of non-surgical interventions tailored to the child's specific needs. This may include stretching exercises, orthotic devices, footwear modifications, and ongoing monitoring of the child's growth and development.
What should I consider when choosing a healthcare provider for my child's foot deformity?
When choosing a healthcare provider for your child's foot deformity, it is important to consider their experience and expertise in pediatric orthopedics, specifically in managing foot deformities. Look for reputable healthcare institutions with a dedicated team of specialists who have a proven track record in diagnosing and treating conditions like Metatarsus Adductus and Clubfoot. Consider seeking recommendations from trusted healthcare professionals or other parents who have had positive experiences with pediatric orthopedic care.