An Affirmation of Independence

An Affirmation of Independence

by | May 8, 2023 | Pediatric Developmental Disabilities

Published in Rite Up, 2023 – Issue 1. 

I’m brave. I’m strong. I’m beautiful. I’m perfect — just the way God made me,” says 8-year-old Jordynn, of Crowley, with her mother, DeAdriene. Together, they practice daily affirmations. “Because of Jordynn’s condition, she is different,” DeAdriene says. “When you’re different, it can be a confidence killer. I want her to be the best version of herself that she can be.”
 
Jordynn was born at 30 weeks and spent six weeks in the NICU. At her 12-month appointment, she could not sit up or walk. Her pediatrician said not to worry about walking until she was 18 months old. “At 18 months, Jordynn still wasn’t sitting up,” DeAdriene says. “We’d have to prop her up in a corner.”

A month later, Jordynn was diagnosed with cerebral palsy, a neurological disorder that affects a person’s ability to move. Jordynn’s condition was caused by periventricular leukomalacia, a type of brain injury that is common in very premature babies. In Jordynn’s case, it affected her legs the most. “When we found out, it was really hard,” DeAdriene says. “We were seeing all these doctors, and they said she would never walk independently.”

Jordynn began wearing leg braces, and at age 3, received a gait trainer — an assistive device similar to a walker that supports a child’s mobility. For long distances, she used a wheelchair. As Jordynn grew, she began taking steps on her own, but she could not put her right foot flat on the ground. “The position of her foot was horrible,” DeAdriene says. “Her braces had stopped working because her muscles were so tight.”

DeAdriene had heard about a surgery that she thought could help. When Jordynn was 5, she was referred to Scottish Rite for Children where they sought advice from a team of cerebral palsy experts, including Lane Wimberly, M.D., medical director of movement science and pediatric orthopedic surgeon, and Fabiola I. Reyes, M.D., pediatric physical medicine and rehabilitation physician.

Jordynn underwent a thorough evaluation, including a gait analysis in Scottish Rite’s Movement Science Lab. The analysis measured Jordynn’s walking ability, which aided in designing a customized treatment plan. Through surgery, Dr. Wimberly lengthened her Achilles tendon and hamstring to get her foot into a neutral position. Over the next year, Jordynn regained strength through physical therapy and home exercises. During that time, Dr. Reyes provided tone management by prescribing medication to relieve Jordynn’s muscle spasms, which completely resolved her pain.

“Scottish Rite has exceeded our expectations,” DeAdriene says. “Jordynn is not only walking, she’s running around with her friends. She’s even on the dance team at school!” “Jordynn is happy and active,” Dr. Reyes says, “and that is our ultimate goal for our patients.”

Read the full issue.

Healio Orthopedics Today: Arthroscopic Meniscus Repair

Healio Orthopedics Today: Arthroscopic Meniscus Repair

by | May 7, 2023 | Press Coverage, Sports Medicine

In a prospective multicenter study, Medical Director of Clinical Research Henry B. Ellis, M.D., and colleagues used the Clavien-Dindo classification system to identify complications among more than 2,000 arthroscopic meniscus repairs in pediatric patients. Presented at the 2023 Arthroscopy Association of North America Annual Meeting, research showed that pediatric patients with an isolated meniscus repair had a complication rate of 14.25% and the team found no statistical cause for the failed meniscal repairs. Read the full article on Healio Orthopedics Today. 
Bike Safety Awareness

Bike Safety Awareness

by | May 5, 2023 | Spotlight

No matter where you live, biking is a great way to get outdoors and be active. Whether it’s for pleasure, to exercise or for commuting purposes, biking has numerous physical and mental benefits — the key is to do it safely.

“Biking is a low-impact resistance exercise that is great for building muscles, improving coordination and increasing mobility, but just like any physical activity, biking comes with risks. Bruises and minor cuts are usually the leading types of injuries involving bicycles, followed by fractures, concussions, muscle strains and sprains. You can significantly lower that risk by taking safety precautions and following the rules of the road,” said Amy L. McIntosh, M.D., FAAOS, orthopedic surgeon, and spokesperson for the American Academy of Orthopaedic Surgeons (AAOS).

May is National Bicycle Safety Awareness Month, which serves as a reminder of the importance of bicycle safety all year long. The AAOS shares the following information about bicycle injury prevention and strategies for how you and your family can stay safe.

Common bicycle injuries
There were more than 325,000 preventable bike-related injuries in the U.S. in 2020, according to the National Safety Council (NSC). Bruises and minor cuts are usually the leading types of injuries involving bicycles, followed by fractures, muscle strains and sprains. However, serious injuries, including death, do occur. According to the NSC, there were nearly 1,260 preventable bicycle-related deaths in 2020.

Helmet safety
No matter what your age or level of experience, you should wear a helmet every time you bike. Cuts, bruises and even broken bones will heal, but damage to your brain can be permanent. Even a low-speed fall can result in serious head injury.

When choosing a helmet, make sure it is:

  • Snug — It should not slide from side-to-side or front-to-back.
  • Level — It should be square on top of your head, covering the top of the forehead. It should not tilt in any direction.
  • Stable — The chin strap keeps the helmet from rocking in any direction. Chin straps should be replaced if any part of the buckle breaks. Otherwise, a helmet may fly off in an accident.

Road safety rules
When biking, it’s important to be aware of your surroundings and follow the rules of the road. Start by familiarizing yourself with the bicycle rules of the road in your city or state, and do not ride if you are looking at your phone or mobile device. Pull over to the side to change your music, check your map or answer a call. Ride in the direction of traffic and always follow traffic signs and lights. Signal your turns or your intentions so that drivers can anticipate your actions, and if you are riding with others, ride in single file.

“Staying alert and aware of your surroundings — even when traffic appears light — can help bicyclists to prevent musculoskeletal injuries,” added Dr. McIntosh.


Choose bike routes wisely
Avoid riding on high-traffic roads and instead select streets with fewer and slower cars. Whenever possible, choose streets with designated bicycle lanes. If there is not a bicycle lane, ride on the right shoulder of the road. When a street lane is too narrow for a vehicle and bicycle to safely ride side by side, or if there are several parked cars on the street, you will need to join traffic and ride toward the center of the road.

Pace yourself and prevent injuries
Cycling can be vigorous exercise, so make sure you are fit enough to participate before you start pedaling. Make sure you understand how to use the gears on your bike to help control your physical exertion level. Additionally, change riding positions periodically to reduce stress on pressure points and avoid overstressing muscles. Finally, stay hydrated by bringing water, especially on longer rides.

Supervise young riders
Whether it’s their first ride or they’ve been cycling for a few years, younger riders benefit from someone watching and advising them. Younger children or people just learning to ride should only do so away from moving vehicles and traffic. New riders may need reminders to avoid distracted cycling.

Visit the AAOS Newsroom to learn more about bike safety, injury prevention and find musculoskeletal facts and figures.

Get to Know our Staff: Sarah Dronzek, Registered Nurse

Get to Know our Staff: Sarah Dronzek, Registered Nurse

by | May 2, 2023 | Spotlight

Scottish Rite for Children attended the 2023 D Magazine Excellence in Nursing Awards, where Scottish Rite registered nurse Sarah Dronzek received an award in the Direct Care category. She and so many other nurses help make Scottish Rite a wonderful place to be for our patients and families. Learn more about Sarah:

How long have you worked at Scottish Rite? How long have you been a nurse?
I was a nurse extern here at Scottish Rite in the summer of 2014. I worked at Children’s Medical Center once I graduated from nursing school, but I came back to Scottish Rite as quickly as I could in September of 2016. I have been a nurse for eight years now.

What area do you work in?
I recently transferred from the inpatient unit to the surgery department. I now work in the Post-Anesthesia Care Unit (PACU).

What do some of your daily tasks look like?
As a PACU nurse, I take care of patients immediately post surgery. I closely monitor their vital signs, levels of consciousness, surgical sites and surgical lines and drains. I help treat pain and manage any adverse effects my patients might develop from surgery and/or anesthesia

What is your favorite thing about being a nurse at Scottish Rite?
I love our patient population and the ability to witness the amazing work our talented physicians perform to help give our kids back their childhood. Scottish Rite is such a wonderful organization, and it feels more like a second family than a workplace.

How does it feel to be recognized for the care you provide?
Words will never be able to describe how deeply honored I am to have received this award. It truly means the world to me, and it validates the dedication and hard work that I’ve put into my career as a nurse. I am astounded by the amount of support that I have received throughout the process of receiving this award, and I cannot thank my nominator enough for nominating me!

Less Common Sports Continue to Grow in Popularity

Less Common Sports Continue to Grow in Popularity

by | May 1, 2023 | Sports Medicine

About two-thirds of kids who come to see us for sport-related injuries play at least one of these five popular sports: soccer, football, basketball, baseball and volleyball. However, young athletes sustain injuries in many other sports and activities.

Download the PDF

The goal of the program is to inform health care professionals who work with young athletes about current concepts and the latest evidence on sport-specific injuries, providing care, returning to sports and preventing injuries. In part two of this program, Jacob C. Jones, M.D., RMSK, provided epidemiology, common injury patterns and recommendations for preventing injuries in softball, tennis, martial arts, rugby, fencing and track & field. This program was presented as a part of a monthly series for medical professionals called Coffee, Kids and Sports Medicine.

Pediatric sports medicine research has been supporting multisport athletes for various reasons including, but not limited to, the benefits that come from the varied skill development and training patterns and demands. Physical literacy is a term that describes how comfortable an individual is with various physical skills. With this in mind, we encourage kids and athletes to test out different sports and activities at varying levels of competitions. Injury risk can be managed in all activities, and knowing what injuries occur in which sports will help with that.

Softball
Softball injuries occur most commonly in the shoulder of pitchers. Much like baseball, repetitive motion, particularly on the growing joint and bones can cause an overuse injury. Because of the style of pitching, the adolescent elbow in softball is at a much lower risk of injury compared to baseball where the elbow accounts for half of injuries in pitchers. The mechanism of shoulder injury is also different in softball, and therefore, it is not diagnosed as Little Leaguer’s shoulder, which is commonly diagnosed in young baseball pitchers. Additionally, the softball pitcher experiences pain much earlier in the season, typically within the first six weeks. Other common injuries among high school softball players include ankle sprains and concussions.

Advice from an Expert – Softball
Katie Holehouse, P.T., D.P.T., CSCS, played softball as a child and earned a scholarship to play at George Mason University. One of her first jobs was as an assistant softball coach in a high school. She has three tips to avoid softball overuse injuries.

  1. Young athletes should take breaks from softball throughout the year.
  2. An appropriate warm-up should include total body movements of all joints – not just the arm.
  3. Strength and conditioning of upper and lower body during off-season can decrease injury risk.

Tennis
Tennis is a combination of quick movements and direction changes with the feet and repetitive, forceful movements with the arm(s). Since the game is not timed, fatigue also contributes to performance and injury risk in tennis.

Repetitive external rotation in shoulder and overextension in spine are the most common causes of injuries. The knee is another joint that is often injured in young tennis players. Joints like the elbow and knee in skeletally immature players will present with conditions that are very different from adults in this sport. For example, tennis elbow, a condition affecting the tendons around the elbow, is much less likely young tennis players than other conditions.

Advice from an Expert – Tennis
Orthopedic surgeon and avid tennis player, John E. Arvesen, M.D., is a three-time Texas High School State Champion and two-time Big 12 Champion at Baylor University. Arvesen offers these tips for preventing injuries in young tennis players:

  1. Dynamic warm-up is key for injury prevention.
  2. Many injuries come from faulty mechanics.
  3. “Throwers Ten” is a good supplement to the serve.
  4. Remember good hydration, especially in the summer.

Martial Arts
All of the different forms of martial arts help young athletes build strength, improve balance and increase flexibility. Additionally, they contribute to improvements in cognitive function, self-esteem, self-respect and self-awareness.
The varying styles contribute to differences in injury risk across the different forms. Some like tae kwon do and grappling may have a higher risk of contact injuries from engaging and striking with the hands, body and feet. In competitions, the head and pelvis are most frequently injured. Contusions and bloody noses are the most common injuries. Weapons may increase the risk of injuries. Meditative forms of martial arts, such as tai chi, have lower risk of contact injuries and offer safety in slow, controlled movement patterns.

Advice from the Experts – Nose Bleeds
Our athletic trainer team boasts more than 50 years of experience in sideline care of young athletes. Their top tip for managing epistaxis (a bloody nose) in martial arts and other sports is “Don’t tilt the head back!” This may lead to swallowing or vomiting of blood. Have gloves, gauze and Vaseline® on hand when the risk for this injury is high. Cutting tampons or purchasing commercially available cotton nose plugs help to slow the hemorrhage.

Rugby
Some sources suggest rugby is the ninth most popular sport in the world. The rules for youth differ from those of adults. Rugby injuries most commonly occur during a match with more than three-quarters of injuries occur during tackling. Proper tackling form is key to help avoid injury. Rugby injuries affect teenage girls most often. The style of play puts the head at the greatest risk of injury and football-like helmets are not used. The lack of protective equipment also contributes to joint and bone injuries, such as fractures, in the clavicles, hands and extremities.

Advice from an Expert – Head to the Hip
Fracture clinic nurse practitioner Ray Kleposki, M.S.N., CPNP, a former rugby player and currently a youth rugby coach, has 20 years of experience in the sport. His advice is to learn proper tackling form, which differs from football — head to the side hip. He advises that learning and following the rules prevents both injuries and penalties.

Rib injuries may not be common in youth sports, but the consequences of misdiagnosis and treatment can be high. Rib fractures are less common in kids compared to adults; however, kids with rib fractures have higher rates of hemothorax/pneumothorax, spleen and liver injury.
Rib injuries with these signs and symptoms warrant further medical evaluation:

  • Cardiac involvement
  • Abdominal injury
  • Trouble breathing, painful breathing and/or coughing
  • Dysphagia
  • Hoarse voice

Fencing
Fencing is a combat sport that is growing in popularity that involves sword fighting. With proper training and equipment, young athletes safely participate in fencing which has three different disciplines:

  • Foil
  • Epée
  • Saber

A competitive fencer typically focuses on one of these disciplines. Each discipline has different weapons, targets and rules. Saber athletes have the highest injury rate with injuries in the knee, thigh and ankle. Anecdotally this occurs more in the lead leg. Other injuries common to other sports may also occur including acute sprains and strains and chronic complaints in the leg are consistent with patellofemoral syndrome. Unique to fencing, puncture injuries are generally prevented with proper equipment.

Track & Field
The variety of events in track & field expose athletes to acute and chronic, or overuse, injuries. The array of injury patterns differs based on the demands of the event. Running, sprinting, jumping, throwing and combination of these requires each event to be considered separately when it comes to injury incidence and risk.

A recent study evaluated youth hurdlers and found the most commonly injured body parts were the ankle, knee and wrist. The injury types that most often cause a hurdler to present to an emergency department are fractures, joint sprains and contusions.

Learn more in an article “Age and Sex Comparisons in Pediatric Track and Field Hurdle Injuries Seen in Emergency Departments of the U.S. Sports,“ recently published in Sports, an international peer-reviewed journal. This article is a review of data from a registry called the National Electronic Injury Surveillance System. Dr. Jones and his peers in the Pediatric Research in Sports Medicine Society studied this information to describe a population that had not been done before. This kind of work helps providers in caring for and helping to prevent injuries in specific populations.