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53
ORTHOPAEDIC SERVICE.
The Orthopaedic Consultant, Mr. J. A. Cholmeley reports:
"For some years the School Medical Department of Ealing
has been particularly interested in the prevention of orthopaedic
disabilities in children and has concentrated largely on foot disorders
caused or exaggerated by unsuitable footwear.
The shoe scheme experiment showed for example that many
early foot and toe deformities could often be corrected by the
fitting of proper shoes, but it was found that there were too many
practical difficulties even for the scheme to become universal
throughout the Borough. These difficulties included the distribution
of footwear in many varieties of fittings and the high cost
of the better class of children's shoes which many parents were
unable to afford.
An alternative simpler method of dealing with the problem
of ill-fitting shoes has been the supervision of the school children's
footwear regularly by one member of the School Department
Nursing Staff and the provision of regular chiropody where required
by a whole-time qualified chiropodist under the supervision of the
School Medical Officers.
The above schemes have been developed in consultation with
the Orthopaedic Surgeon attending the Borough clinics, and by
these simple means many minor foot disabilities have been
adequately dealt with without the necessity of the child attending
the School Orthopaedic Clinics.
There are, however, always cases requiring more specialised
supervision and treatment than can be obtained at the schools or
the ordinary school clinics. These are referred by the School
Medical Officers to the School Orthopaedic Clinics at Mattock
Lane, Ealing, and Ravenor Park, Greenford. At these clinics during
the year 1951, 152 new cases and 573 re-inspections were carried
out, totalling 725, which compares with 560 for 1950 and 617 for
1949, showing that the advent of the National Health Service has
certainly not reduced the number of school children requiring
examination and supervision by an orthopaedic specialist. In
addition to these examinations during 1951, 252 cases were referred
for treatment by the clinic physiotherapists and these school
children made a total of 1,910 attendances. Here again there has
been a considerable increase in the number of cases and attendances
during the past three years.
A service such as is available in Ealing keeps down the number
of children requiring in-patient orthopaedic hospital treatment,
but where this is required the patients are admitted under the care
of the visiting clinic orthopaedic surgeon to the Royal National
Orthopaedic Hospital, thus providing continuity of treatment and