Questions for a pediatric surgeon

The baby has an umbilical hernia, fracture, a suspicion of phimosis? With all these questions, parents are sent to a pediatric surgeon. All that you need to know before we go to a consultation with a specialist, we asked our expert.

To the son 11,5 months. When he strains, the navel slightly protrudes outward. Is this a sign of the umbilical hernia? How can I treat it to avoid surgery?

Marina, Cheboksary

The protrusion of the umbilical fundus bottom with the tension of the abdominal muscles is a reliable symptom of the umbilical hernia. But all the same the child should be examined by the surgeon in order to determine the size of the defect. For small defects (up to 1 cm), the baby is observed up to 4-5 years; if the symptoms do not disappear, it is operated on. Conservative treatment is effective during the first year of life, but it is appointed by the surgeon. This massage, physical exercise, mechanical fixation and covering the defect with a special plaster. Results, as a rule, are visible after 1-2 months from the beginning of treatment.

The son (he is 2 years old) has small spikes on the foreskin. The polyclinic was told that, most likely, they are physiological and will pass by themselves. But, maybe, while it's not too late, does it still need to be treated? How are spikes treated at the foreskin and at what age? How can spikes in this place affect the child's further development?

Svetlana, Pushkin

The adhesions between the foreskin and the head of the penis are called synechiae. This physiological condition does not require treatment: it does not deliver discomfort to the child and does not affect his sexual development. Synechia independently "dissolves" under the influence of hormones during the puberty period of a boy (from 9-11 years old). Some doctors, motivating by the fact that under them is accumulated smegma and there is a risk of inflammation, insist on breeding synechia. But manipulation can lead to traumatization of the head, in addition, it is painful. The operational separation of synechia is prescribed only if they remain after the onset of puberty.

At the 3-year-old daughter fracture of an anticnemion (has slipped on a rug) without displacement of bones. She was plastered. I'm worried: Will gypsum prevent the growth of bones? Heard that the children do not always cast plaster. Is it so? When can I do without it?

Irina, Kostroma

If the growth zones are not affected, then the growth of bones will not hurt, even plaster lingeta, because gypsum in uncomplicated fractures are no more than 2-4 weeks. Babies younger than a year, gypsum, it happens, do not impose because of the physiological characteristics: they have a periosteum (the film that surrounds the bone) thicker than the bone - and reliably fixes it. At 3 years, when the bone thickens, with a fracture, the periosteum can no longer fix it. Therefore, it is possible to dispense with gypsum if the child is immobile during the whole period of bone healing (2-4 weeks), which in principle is impossible. The timing of wearing gypsum is determined by a trauma doctor. After removing the gypsum, rehabilitation of the fractured limb (massage, physiotherapy exercises) will be required, since the muscle tissue of the limb decreases with a prolonged absence of exercise (you can visually notice the difference in the volume of a healthy and broken leg).

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