Ask the Expert: Dr. Daniel Green, Pediatric Orthopedic Surgeon, Answers Your Questions About Pediatric Sports Injuries
Q1. My 15-year-old son plays football and one of his teammates injured his shoulder. Is it common for adolescents to get shoulder surgery for major injuries?
Shoulder injuries in teenagers are common and can vary greatly. Clavicle or collarbone fractures are especially common. These injuries can be treated conservatively so the patient can get back to the football field within 4-6 weeks. Only severe cases require surgical intervention. Another common shoulder injury involves dislocation or instability. Teens who experience pain in their shoulder after a dislocation typically undergo a focused rehabilitation protocol and a recommended MRI examination to evaluate the severity of their injuries. Hospital for Special Surgery takes care of many adolescents with recurrent shoulder dislocations through an outpatient arthroscopic shoulder stabilization procedure.
Q2. I read that vitamin D can help reduce the risk of a stress fracture in girls. How much vitamin D do girls need to take daily?
For kids and adolescents with stress fractures, HSS conducts a blood test to check for vitamin D levels. For those with low levels, we usually prescribe high doses of vitamin D. For adolescents with adequate levels, we recommend a minimum of 600 units a day. Many physicians recommend 1,000 units a day. Kids and adolescents can also get vitamin D by being in the sun and drinking fortified milk. It is important to consult with your doctor.
Q3. How do you treat an ACL tear in children?
Complete ACL tears in active children can lead to developing other joint injuries such as meniscus tears and articular cartilage injuries as well. ACL reconstructive surgery can be performed safely in children without disruption to the surrounding growth plates. The surgical treatment principles for children are similar to those in adults but with additional steps and inter-operative x-rays to minimize the chance of damage to the growth plates around the knee.
Q4. How long does it take for a muscle sprain to heal in children under 10 and how would you treat it?
Typically mild muscle sprains or contusions can heal within a week. Children experiencing severe pain or prolonged episodes of pain more than a week should be evaluated by physician to rule out other types of injury. Similar to adults, children should rest, apply ice and compression, stretch and consider physical therapy.
Q5. My 9 year-old daughter broke her leg while playing soccer. Will the broken leg affect her growth?
Leg fractures can involve growth plates and also occur outside of growth plates. Lower extremity fractures with growth plates aren’t uncommon and 20-30% of such fractures can lead to growth arrest. If this occurs, physicians typically develop a surgical plan to correct the problem.
Dr. Daniel Green specializes in Pediatric Orthopedic Surgery at Hospital for Special Surgery. He is currently director of the pediatric sports program for the Division of Pediatric Orthopedic Surgery at HSS. Dr. Green’s focus is to provide the finest, most advanced orthopedic care available, with expertise in areas such as pediatric sports injuries, pediatric fractures, and dislocations.