Orthopaedics Department

Consultants

Specialty Doctor

Physiotherapists

Orthopaedic practitioners

Secretaries

We provide emergency care because the RHCYP is a Major Trauma Centre, meaning that our patients can come from across the southeast of Scotland and Edinburgh and the Lothian area.  Children can also come to us from all across Scotland for ‘elective’ treatment, which means non-emergency treatment is decided with doctors, young patients and their families.  We also have specialist clinics run by dedicated multi-disciplinary teams (this means groups of different specialists all working together to care for a patient). Our clinics include:

• Orthopaedic trauma and post-trauma rehabilitation

• Musculoskeletal infection multidisciplinary care
• Limb reconstruction service
• Gait analysis clinic
• Orthopaedic neuromuscular hip reconstruction and gait improvement surgery
• Developmental dysplasia of the hip (DDH), including expert, physiotherapy-led screening, and treatment of late-presenting DDH
• Club foot service following Ponseti protocols, led by super-specialist physiotherapists

• UK national referral centre for hereditary multiple exostoses
• Paediatric and adolescent knee service
• Upper limb service, with joint plastic surgery and orthopaedic clinic
• Spina bifida specialist multi-disciplinary clinic
• Orthopaedic oncology care delivered jointly with our colleagues at RIE.
• Bone metabolism clinic with paediatric endocrinologists and super-specialist physiotherapists
• Specialist plastering, casting and orthotic service
• Wire removal clinic led by specialist practitioners

Most orthopaedic clinics are based at the Royal Hospital for Children and Young People (RHCYP) in Edinburgh.  You can read more about coming to an outpatient clinic. We also offer ‘close to home’ outpatient clinics and care for patients who do not need operations at locations in West Lothian and Fife and gait analysis and orthotic care at the SMART Centre at Astley Ainsley Hospital in Edinburgh. If you have a clinic appointment, please check your letter carefully to know where to come. Some children and young people have problems with their bones' shape as they grow, particularly in their backbone or spine. The Scottish National Spinal Deformity Service Opens in new window is based at the RHCYP.

After an injury like a broken bone, a follow-up appointment might be made to come to Fracture Clinic as an outpatient. Before your visit to Fracture Clinic, you might have been seen at the Emergency Department, or Minor Injuries Unit. Coming to Fracture Clinic means that you can see a specialist nurse, doctor or physiotherapist who is trained to look after injuries affecting bones, muscles, joints and tendons. You might only need to come once, or you might have several appointments over a few weeks – everyone is different.

Making an appointment at Fracture Clinic

In many cases, an injury will be expected to heal without any complications. Sometimes a review appointment is arranged for you before you leave the Emergency Department or hospital ward (if you have stayed overnight). If an injury is not getting better as expected, you can ask for a review appointment at Fracture Clinic. Please phone and ask to make an appointment for us to either telephone you or see your child in our review clinic. Our contact numbers are: 0131 312 0007 0131 312 0008 (Monday - Friday, 8:30 am - 4 pm)

Coming to Fracture Clinic

Fracture clinics are held on Tuesday afternoons and Friday mornings at the Royal Hospital for Children and Young People (RHCYP) in Edinburgh. When you arrive, check in at reception in the main Outpatient area on the ground floor. After that, you will be shown where to wait or might be asked to go to our Imaging Department for an x-ray or scan first. Appointments can take up to 45 minutes – sometimes longer if x-rays are needed, or a cast is removed or replaced. Sometimes you might see a physiotherapist while you are there and there can be some waiting time between different parts of the appointment, for example after an x-ray or before having a cast or dressing changed. Fracture clinic can feel like a busy place – it might seem like some people who arrive after you might be called before you, but everyone is there for a different reason and there is usually more than one doctor, nurse specialist or physiotherapist reviewing patients. It can be helpful to wear loose, comfortable clothing to make it easier to look at your injury, or how your body is moving. It is sometimes helpful to think about any questions you might want to ask before you come – some people find writing them down can help them to remember. The RHCYP is a teaching hospital and there may be medical and physiotherapy students, student nurses or doctors training to be specialists at Fracture Clinic. If you do not want a student to join your review meeting or appointment, please let one of the nursing team know when you arrive. The RHCYP Outpatient waiting area is bright, comfortable and has plenty of toys, games and activities. There are accessible toilets and baby change facilities. Explore the interactive Pod, watch a movie on the big screen or do some painting at the arts and crafts table while you wait. You are welcome to bring a favourite toy or something to help you feel calm and relaxed. Our Play Specialists are often in the waiting area and if there is anything you are feeling worried or scared about, let us know so that we can answer any questions, or explain what is going to happen.

Need to change your appointment?

If you have a scheduled appointment at Fracture Clinic but can’t attend on that date or are running late, please let us know by calling 0131 312 0007 or 0131 312 0008.

What is an Orthotist?

An Orthotist is a specialist trained to understand and improve how the body moves. An Orthotist assesses for and designs devices or supports (known as orthoses) to help with walking, prevent deformities, improve hand function, allow children using wheelchairs to stand safely or to reduce pain in joints or soft tissue.

What is an orthosis?

An orthosis is a support which is worn anywhere on the body, from head and neck, spine, arms and hands to legs and feet or is placed in a shoe to improve foot position and help with walking. It can be made of plastic, rubber, or fabric with metal hinges. These can be either off-the-shelf stock products or made fully-bespoke (to fit).

What conditions benefit from orthoses?

Many conditions which affect children’s mobility can be helped with orthoses. These might include cerebral palsy (CP), clubfoot (CTEV), spina bifida, chromosomal abnormalities, arthrogryposis (a type of joint condition), muscular dystrophy, chronic joint or muscle pains. Sometimes children with a learning disability or developmental delay can benefit from an orthosis. They can also be used to treat musculoskeletal conditions like plantar fasciitis, flat feet, muscle, tendon and ligament sprains.

My child has been referred to Orthotics, what happens next?

Your child will be placed on a waiting list, and an appointment to be seen face-to-face or for a telephone consultation will be sent to you in the post.

Where will my child be seen?

Appointments take place in the Outpatients department of the Royal Hospital for Children and Young People (RHCYP) in Edinburgh. Each appointment letter will have details of exactly where to come, along with the date and time.

What happens at the appointment?

The Orthotist will ask about your child’s development and recent medical history, including the aims and goals from any treatment. There will be an assessment of your child’s joint ranges of motion, muscle powers, foot posture and walking. Recommendations will be discussed along with different stock or custom-made options for any orthosis needed. If it is agreed that a custom-made ankle foot orthosis (AFO) is needed, a plaster cast of the leg from calf to end of toes will be taken. This takes around 5 minutes to set and will be removed then used to create the AFO. Sometimes we will draw around feet, or put them into a box with soft, squashy foam or take lots of different measures depending on what kind of support is needed.

Will it be uncomfortable for my child?

Normally no, but we may have to find where it hurts, if your child is experiencing pain. Some children may feel a stretch on their muscles during their examination.

Do I need to bring anything to the appointment?

Please bring your child a pair of shorts (or come wearing them). Favourite toys or books from home can help children to stay calm or feel reassured. If you are returning for a review please bring your child’s current orthosis with you, (even if they are now too small).

How long will the appointment take?

Please allow 45 minutes to one hour depending on the type of appointment.

Will my child receive an orthosis at their first appointment?

Your child may be given a stock orthosis at their first appointment or they may have to come back for a fitting appointment of something which is custom made for them. (this is usually 4-6 weeks after a first appointment).

Should I buy new shoes for the appointment?

No, it is best to buy new shoes once your child has been supplied with the orthosis. Please bring their current pair of shoes as this will allow the Orthotist to look at the tread to see how your child has been walking.

Contact details

Orthotic department, SMART Centre, Astley Ainslie Hospital, Grange Loan, Edinburgh, EH9 2HL
Phone: 0131 5379418 or 0131 5379479 (Monday-Friday, 9am – 4pm).

Useful information & leaflets

ECO has a long history of publications in highly-regarded, peer-reviewed journals and a robust clinical research programme. The national CPIPS (Cerebral Palsy Integrated Pathway Scotland) is led by an ECO consultant and has its ‘home’ at RHCYP. The UK national group is also chaired from here, and this is driving the roll-out of this internationally recognised programme forward in the rest of the UK and beyond.

We are passionate about delivering first-class training to improve future patient care. We enjoy strong links with Edinburgh University and regularly host undergraduate medical students and students studying nursing, physiotherapy and other allied healthcare professions. Orthopaedic speciality trainees rotate through the department, and they have given our training the highest possible rating on GMC surveys.