General Principles

Abstract

The correction of deformities in children may be regarded as the purest form of orthopaedics, which translated literally means correct (ortho-) child rearing (paideia). In the field of adult orthopaedics, the concept of straightening deformed children, as exemplified by the internationally recognized tree of Andry, seems a little remote, but not to the children’s orthopaedic surgeon for whom this is part of routine practice. Andry would have been familiar with deformities arising from a number of causes which have become much less common in orthopaedic practice in the developed world, such as pyogenic sepsis and tuberculosis. The problems of deformity resulting from infection, congenital malformations, and trauma remain major causes of disability in the developing world. In Rwanda, for example, it is estimated that 5% of the population has significant musculoskeletal impairment, nearly half of which is the consequence of congenital abnormality, infection, or trauma (CBD Lavy, MD: written communication, 2007).