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Six Ways to Prevent Toddler Fractures

Six Ways to Prevent Toddler Fractures

by | Feb 9, 2023 | Fractures

According to Gerad Montgomery M.S., F.N.P.-C. from our Fracture Clinic, toddlers are naturally at an increased risk for certain fractures and other injuries. This is because they are in a phase of rapid growth, very active and very unsteady when walking. Toddler’s bones are soft and will often break or buckle with seemingly harmless injuries. He tells us that many injuries that cause a sprain or strain in an adult will cause a fracture in a toddler. The good news, for patients like 22-month-old Kye, is that these injuries generally are stable and do not require casts or splints for very long, if at all.

Here are some common toddler injuries we see in our Fracture Clinic:

Toddler’s fracture is a small break in the bone of the lower leg usually caused by a simple fall or a twisting injury. A common way these injuries occur is when a child’s foot is caught on a playground slide while going down the slide with a parent.

Nursemaid’s elbow occurs with a sudden forceful pull on an outstretched arm. This may happen when someone picks up the child or swings him or her by the arms. With this problem, the child often refuses to use the arm and holds it in a flexed position.

Fingertip injuries occur in thousands of young children each year, and they typically wind up in an outpatient clinic or emergency room. These injuries often result from accidents with common items such as home and car doors, drawers or scissors.

Broken bones from falls and collisions occur when playing with larger, stronger and faster kids or on equipment that is not age-appropriate.

Lessons to Learn:

  • Do not pick up or tug on your child while holding only his or her hands or wrists; this can put stress on the elbow.
  • Do not swing your child around when holding only their hands or wrists.
  • Toddlers should use age-appropriate playground equipment and slides.
  • Toddlers should ride down a playground slide alone.
  • Watch your toddler closely when climbing or playing with bigger kids.
  • Doors, drawers and sharp objects are not toys and young children should not play with them.

As experts in managing fractures and other injuries in growing bones, we are here for you when you need us. Learn more about our Fracture Clinic

Get to Know our Staff: Paola Sparagana, Research

Get to Know our Staff: Paola Sparagana, Research

by | Jan 26, 2023 | Research & Innovation

Each year, our team seeks out college students interested in pursuing a career in medicine. Clinical Orthopedic Research Assistants (CORA) are hired at Scottish Rite for Children to assist our experts in performing clinical research tasks and collaborating on research projects. CORA staff are also mentored by our physicians and researchers and given valuable advice and guidance for their future. Each CORA staff member specializes in a specific area of study and works with the staff in that department, receiving a well-rounded experience in their field of interest.
 
What inspired you to apply for the CORA position?
What initially inspired me to apply for a CORA position was the sheer uniqueness of the program. Not only was this an opportunity at a globally distinguished hospital, but it also offered numerous opportunities that seemed essential for my professional growth. The CORA program is tailored toward those who are interested in pursuing advanced degrees in medicine. So, unlike other research assistant positions, CORA offers opportunities that are crucial in creating a competitive applicant for any medical degree program. Such opportunities include designated hours for observing in clinic, developing your own research project and learning from true experts in their field. As someone who had minimal experience with clinical research, this seemed like a terrific opportunity to formally introduce myself to the wonderful world of research!
 
Have you always been interested in medicine and/or research?
I grew up with two parents in the medical field, so it certainly has always felt like a natural topic of interest to me. Despite always having this interest, I wasn’t sure what that meant for me and my future. I never experienced a defining moment where I thought to myself, ‘Yes, medicine is it for me!’ In fact, even up to my senior year of college, I found myself wondering if medicine was just an interest or if this had the potential to be a lifelong career. Fortunately, I found myself at Scottish Rite for Children, where my experiences have gradually transformed interests into ambitions and passions.
 
What is it like working at Scottish Rite for Children?
I certainly have a sense of pride when I come to work. Since its inception, Scottish Rite for Children has maintained a reputation of providing extraordinary patient care and pioneering revolutionary research. The staff and volunteers here are a true testament to the excellence of this organization. Working with children is a humbling experience, but that is a feeling that we all need to learn to embrace. In fact, I often find myself learning valuable lessons from the short interactions I have with the children in clinic. There is so much to learn here, and I am beyond thrilled to be a part of the community!
 
Can you share a few sentences about someone at Scottish Rite who has been a mentor to you and how they have impacted your experience? What project are you working on with that mentor?
While working here, I have had the opportunity to learn from some truly impressive individuals. Within the Rheumatology department, Lynnette Walters has selflessly invested a significant portion of her time into my own professional and personal development. Within a few short months, Lynnette reinforced my abilities to lead with positivity and integrity. I am currently working on an autoimmunity project with Lynnette that consists of obtaining biological samples and examining disease manifestation at the time of sample collection. Julie M. Fuller, M.D., who is mentoring me through a personal project, has also given me direction and confidence since the start of this project.  
 
How do you think this experience will impact your career path?
It has unquestionably already impacted my career path. This experience has solidified my interests in medicine while giving me clinical experience that goes beyond most entry-level positions. I believe this program has solidified the foundation for my professional career while reinforcing my personal development.  
 
What progress have you made toward your career goal since beginning the program?
The CORA program has helped me not only identify my career goal, but it has also helped me set some crucial career development goals. One important aspect of my career development was gaining exposure to other departments and specialties. I have had the opportunity to work with multiple departments such as Rheumatology and Pediatric Developmental Disabilities. Working with different departments has enhanced my workplace flexibility while also allowing me to step outside my job description and create new opportunities for myself. As I have grown more comfortable in my role, I have felt confident in accepting new tasks and projects that had once seemed daunting. Experience has only made me more confident myself!
 
What is your favorite project that you are currently working on or have worked on at Scottish Rite?
My favorite project is probably my own personal project that I am working on with rheumatologist Dr. Fuller. We are working on a case series examining patients with Juvenile Idiopathic Arthritis (JIA) who also present with Temporomandibular Joint involvement. Getting to work through the challenges of research with Dr. Fuller has given me invaluable experience into the fundamentals of the research development. It is incredibly rewarding to watch an idea transform into a project that you can call your own.
 
What advice do you have for future CORA participants?
My first piece of advice would be to embrace the work that is given to you. It is unlikely that you will always know what to do when assigned a new project, but in chaos there is always opportunity! If you use this as an opportunity to learn, then you’re only better preparing yourself for the future. My next piece of advice would be to allow this experience to be more than just professional development. Let this be a time of personal growth for you. Explore your talents, potential, dreams and aspirations. At the end of the day, it is personal growth that gives us the motivation to accomplish meaningful work and advance in our careers. 
 
What is one thing most people don’t know about you?
Prior to this position, my only true research experience was at Texas A&M, where I helped develop open-education resources (OER) for second language education. We developed textbooks that are now used by Introductory Spanish courses at Texas A&M, which provide students with free textbooks! So, despite my minimal experience with clinical research, I believe it was my eagerness to learn fast and prioritize the information needed that has allowed me to excel in this position.
 
Anything else you would like to add?
The CORA positions are a great opportunity at an outstanding institution with world class medical staff and colleagues. I give the program my most heartfelt endorsement!
 
If you are interested in a career in medicine and plan to take a year or two after college before applying to medical school, learn more about becoming a clinical orthopedic research assistant (CORA) on our careers page. Applications for June 2023 positions are being accepted through spring of 2023.
 
If you are in medical school and are interested in a research opportunity, learn more about becoming a medical student research fellow (MSRF) on our careers page.
Researchers At Scottish Rite For Children Awarded Grant From National Institutes Of Health For Clubfoot Genetics Research

Researchers At Scottish Rite For Children Awarded Grant From National Institutes Of Health For Clubfoot Genetics Research

by | Jan 17, 2023 | Research & Innovation

Researchers at Scottish Rite for Children and UT Southwestern Medical Center were recently awarded a grant from the National Institutes of Health (NIH) that will bring new opportunities to discover genetic causes of clubfoot. Clubfoot is a complex foot deformity where one or both feet are turned inward and pointed downward. At Scottish Rite, two nonoperative treatment methods are provided to children with clubfoot, though at times, surgical management may be required.
 
A research team at Scottish Rite, led by Jonathan J. Rios, Ph.D., is investigating the genetic basis of clubfoot. In 2021, Dr. Rios’ team published the largest genetic association study for clubfoot, which included analysis of approximately 8 million genetic markers in more than 8,000 individuals. As part of this effort, his team identified the first gene, FSTL5, associated with clubfoot using this approach. Using similar strategies, Carol Wise, Ph.D., Director of Basic Science Research at Scottish Rite, has led studies discovering genes associated with adolescent idiopathic scoliosis. “This award reflects the expertise of our research staff and the organization’s commitment to research excellence, a combination that enables continued discoveries of the genetic basis for pediatric orthopedic conditions treated at our institution,” Dr. Wise says.

Dr. Rios’ new award will utilize whole-genome sequencing to discover genetic causes of clubfoot. As part of this award, the Gabriella Miller Kid’s First Program will sequence the entire genomes of 407 individuals from 85 families with clubfoot. “The Gabriella Miller Program is a unique opportunity to apply comprehensive genomic technologies to tackle unanswered questions in the field and to discover genetic causes of pediatric orthopedic disorders,” Dr. Rios says. The new Kids First Project on Congenital Clubfoot, led by Dr. Rios, is a collaboration with Dr. Jacqueline Hecht, Associate Dean of Research at the McGovern Medical School at UTHealth Houston.

This is the second Gabriella Miller Project awarded to Dr. Rios. In 2016, the Gabriella Miller Project awarded Drs. Rios and Wise’s study of adolescent idiopathic scoliosis, which included whole-genome sequencing of 598 individuals from 168 families. “Scoliosis and clubfoot are the most frequent orthopedic conditions treated at Scottish Rite,” says Scottish Rite Chief of Staff Daniel J. Sucato, M.D., M.S. “Genetic and basic research is fundamental to improving how we care for children, and ‘big data’ studies such as these allow our scientists to tackle new research questions that will advance our understanding of these conditions.” Learn more about research at Scottish Rite for Children and the Scottish Rite for Children Molecular Genetics research team. Jonathan J. Rios, Ph.D., is the co-director of Molecular Genetics at Scottish Rite, as well as an associate professor in the McDermott Center for Human Growth and Development and the Departments of Orthopaedic Surgery and Pediatrics and is a member of the Simmons Comprehensive Cancer Center at The University of Texas Southwestern Medical Center (UT Southwestern). Carol Wise, Ph.D., is the Director of Basic Research at Scottish Rite and is a professor in the McDermott Center for Human Growth and Development and the Departments of Orthopaedic Surgery and Pediatrics at UT Southwestern. Daniel J. Sucato, M.D., M.S., is the Chief of Staff at Scottish Rite and is a professor in the Department of Orthopaedic Surgery at UT Southwestern.

Get to Know our Staff: Madelyn White, Therapy Services

Get to Know our Staff: Madelyn White, Therapy Services

by | Jan 13, 2023 | Therapy Services

What is your job title/your role at Scottish Rite for Children?  
I’m a sports physical therapist at our Frisco campus.
 
What do you do on a daily basis or what sort of duties do you have at work?
I work with youth athletes with various injuries to get them back to their sports safely. My job consists of examining and assessing athletes and coming up with a plan to get them back to their sports. I spend most of the day in our sports therapy gym, leading patients through exercises tailored to their injury and their sport. 
 
What was your first job? What path did you take to get here or what led you to Scottish Rite? How long have you worked here?
Prior to becoming a physical therapist, I worked at an ice rink teaching young kids how to skate and play hockey. 
 
My first job as a physical therapist was here! I was a student physical therapist at Scottish Rite for Children for my final clinical rotation, and I started working as a full-time physical therapist about a year later in March 2021. 
 
My family lives in this area, and I remember seeing the Frisco facility being built. I thought it was really unique to have such a specialized clinic for youth sports, and I knew I wanted to be a part of it. After having my clinical rotation here, I couldn’t imagine working anywhere else. I feel very lucky to get to work in such a great facility.
 
What do you enjoy most about Scottish Rite?
The people! Whether it’s my patients or my colleagues, it’s always fun to be here. We have such a great staff in the Therapy Services department and beyond, and my patients always brighten my day!
 
Tell us something about your job that others might not already know?
I think most people don’t know how hard physical therapy (PT) sessions are for patients. A lot of people think PT is just massages and stretching, but most patients spend the majority of sessions lifting weights, running and jumping. There is a lot more strength and conditioning involved than people expect.
 
Where is the most interesting place you’ve been?
I went to Europe for the first time last summer and loved it. Paris was the most beautiful place I’ve ever seen. 
 
What is your favorite game or sport to watch and play?
Ice hockey! I grew up in a hockey family, and I played and/or coached ice hockey until I went to college. I’m a big Dallas Stars fan and go to (almost) all the home games.
 
I also had a brief stint as a gymnast/cheerleader, and I ran track throughout high school. 
 
If you could only eat one meal for the rest of your life, what would it be?
Any kind of sushi.
 
What’s one fun fact about yourself?
I am currently on a daily running streak and have run at least one mile a day for more than 450 days in a row. I haven’t missed a day!
Share Your Story: Cambryn Mannos – Redefining Myself

Share Your Story: Cambryn Mannos – Redefining Myself

by | Jan 12, 2023 | Hip Disorders

Blog written by Cambryn, and Cambryn’s mom, Amy.

Go back a year and you could find me, Cambryn, age 9, training with the best team and best coaches in all of New Mexico. My sport is gymnastics — the sport of all sports that defines toughness, perseverance and dedication. Winning competition after competition, I was defined as the best in my age group, hardworking, fearless, fireball, hotshot and destined to be counted among some great gymnasts. I was born into gymnastics, raised at Gold Cup Gymnastics School and the true definition of a “gym rat” with two older siblings competing. The gym is where you could find me all day, every day! Until the day it all came crashing down. It began with hip pain surging with every landing and movement in any backwards motion, including back walkovers, back tucks, back handsprings and back layouts.

My ability and stability were gone, just like that. I visited my orthopedic doctor right away at the request of my head coach, and on the X-ray, the doctor saw a fracture on the head of my left femur. An MRI was ordered, and while waiting, my ability to walk was gone by Christmas Eve. My MRI was now on stat order, and BAM, with all its glory, my MRI lit up black spaces through the head of the femur, showing avascular necrosis and Legg-Calve-Perthes disease, big words that I did not understand.

I struggled to find words to define my thoughts. I was referred to another orthopedic doctor in pediatrics, and “wait and see” was the advice. Then, my hip collapsed. All that I was and all that I thought I could be vanished, my definition of myself was gone. I lost it all! And yet again, “wait and see” was the approach. Now I needed a wheelchair, except after three months, I was still on a waitlist to get a wheelchair. 

Nothing seemed to happen but waiting, and I could see nothing in my future to be but that same blackness or death of what I was and what I could be. Gymnasts don’t “wait and see,” they are proactive and always in a constant state of motion. This is where my redefining journey begins with Scottish Rite for Children. With help from my teammate’s dad, who is a doctor, we found Dr. Harry Kim and his nurse Ms. Kristen. Their knowledge and dedication are a priceless need for us Perthes kids. They gave light to the blackness I saw because they had a game plan! 

Now, the beginning of the fight to redefine myself is not my proudest moments. I have had to do some soul-searching and letting go of a lot of pride and previous definitions of myself to build the “Perthes” me. Because at first, I freaked out at Dr. Kim. “He wants what? Six weeks in a huge cast? Nope, not doing that,” was my response. Yet, this summer, I did the tenotomy and petri casting, and I survived and even thrived with some new adventures. Dr. Kim is amazing, kind, patient and willing to fight my battle with me. Because of him, I know that Scottish Rite for Children is the place for me to get better and be a part of something bigger. You become family at Scottish Rite. I gained family. My care each time I go has been top of the line care. It’s worth the 1,400-mile trip to see my Scottish Rite family and to belong to something big, progressive and healing. 

Today, I find myself in stage 3 of Perthes disease, rebuilding new bone and redefining myself in all that I lost and in all that I have gained. I can grieve what I lost, and I can work hard to regain most of what was lost, but mostly I can seek moments that empower myself so I can empower others. I recently took photos for gymnastics. At first, I was embarrassed at the thought of gymnastics photos with a wheelchair. But the photographer, Kevin Lange, helped me see a bigger picture. I embrace Perthes disease because it is a part of me now, and I can’t change that, but I can choose what I do with it. I choose to find joy and strength in my Perthes journey. To me, Scottish Rite means the chance to regain and redefine myself! It means a new family of people who care about my health. It means everything to my future self who cannot fight this battle alone.

Thank you, Dr. Kim and Ms. Kristen, for your time and energy, for your dedication and expertise. 

Other than gymnastics, I enjoy rock climbing, math, animals, bike riding, hiking and art.

Photo Credits to Kevin Lange

 

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