Eman’s Quiet Confidence Shines Through the Reconstruction of Her Leg
Published in Rite Up 2026, Issue 3.
The night before her surgery at Scottish Rite for Children, Eman found a quiet place to sit, reflect and pray. “I let go of all the anxieties and fears that were going through my head, and a wash of ease came over me,” she says. “I was able to put full faith in what was ahead of me, in my doctors and their plan.”
From Ontario, Canada, Eman is 17 years old and lives with her mother Samia in Houston. They came to Scottish Rite for another opinion after Eman had undergone various unsuccessful treatments from multiple healthcare institutions for her leg.
At the age of 3, Eman fell out of bed and fractured her right tibia, or shin bone. X-rays revealed her bone was not normal, with what appeared to be a benign bone tumor weakening her bone.
She was diagnosed with osteofibrous dysplasia (OFD), a rare bone disorder in which normal bone is replaced with abnormal bone and fibrous tissue that forms a slow-growing benign tumor. OFD tumors can become worse over time, cause the bone to change shape and increase the risk of fractures. Additionally, as a child gets older, the tumor may become malignant, or cancerous.
Unfortunately, Eman fractured her right tibia a second time, and when she was 6, surgeons in Canada placed a rod in her leg to decrease the risk of recurrent fractures and guide bone growth. After surgery, Eman experienced a known complication from tibia rod placement called compartment syndrome, a painful condition that affects circulation, causing muscle weakness and loss of sensation in the nerves. She spent months in the hospital and later at a rehabilitation center receiving physiotherapy. “I wasn’t able to walk,” Eman says. “I had a very hard time regaining my walking ability and gaining back sensation that I lost in the bottom of my foot.”
After that experience, Samia and Eman moved to the Middle East to spend time with family. “We took a break from the negative experiences and emotional toll that we had endured in Canada,” Eman says. “We spent a lot of time with family, which was really nice.”
A few years later, they moved back to Canada. “What had been surfacing was my limb length discrepancy, which caused a pretty pronounced limp in my gait,” Eman says. Her right leg had become shorter than her left leg, and she started wearing high-top sneakers with a shoe lift. “Because of the leg length discrepancy, I put a lot of pressure on my shorter leg,” Eman says. “I was not confident in my ability to walk, and I felt emotionally exhausted.”
After reevaluating her leg at multiple treatment facilities and feeling ignored, Samia and Eman moved to the United States. Eman underwent another surgery that improved the position of her foot, but she did not see a significant change in her gait or the pain she experienced while walking. The doctors recommended amputation or shortening her left leg to equal the length of her right leg. Discouraged by these options, Samia asked for another opinion and was referred to Scottish Rite for Children.
At Scottish Rite, Eman saw David A. Podeszwa, M.D., pediatric orthopedic surgeon and director of the Center for Excellence in Limb Lengthening and Reconstruction. “Eman has by far the most extreme case of OFD we’ve ever seen,” he says. “She had a tumor the size of a cantaloupe. In addition to the cancer risk, the growing tumor caused a massive deformity in her leg, affecting the shape of her leg, the length of her leg and the function of her foot and ankle.”
After a long list of negative healthcare experiences, Eman says she felt on edge about seeing someone else. But, in her first conversation with Dr. Podeszwa, he discussed something she says no other doctor had addressed before — her tumor. “Every other doctor I’d seen was too worried about damage that could happen if they touched my tumor,” she says. “Dr. Podeszwa and his team immediately wanted to get rid of what had been in my leg my whole life, and they opened my eyes to see something that I didn’t realize was the core of all my issues.”
Hand surgeon and microvascular specialist Scott Oishi, M.D., FACS, collaborated with Dr. Podeszwa to define a customized treatment plan for Eman that would begin with a 12-hour surgery. Before the procedure, Eman had a series of visits with pediatric psychologist Whitney M. Herge, Ph.D., who not only prepared her for treatment but also helped her confront her past experiences.
“I was overwhelmed and reluctant to put my trust in something else after having done that before and not seeing a positive outcome,” Eman says. Over many months, she discussed with Dr. Herge what had happened to her, who she was and what she wanted. “Dr. Herge made me feel comfortable and in control of my health.”
Eman emphasizes that no other hospital had cared for her mental health. “It was a game changer to see that there was a team of people at Scottish Rite who were looking out for my mental health as much as they were looking out for my physical health,” she says.
In January, after a time of reflection and prayer, Eman, at ease, entered the operating room. An expert, multidisciplinary team of surgeons performed the operation, including pediatric orthopedic surgeon and musculoskeletal oncologist Alexandra K. Callan, M.D., pediatric orthopedic surgeon Elizabeth W. Hubbard, M.D., Dr. Oishi and Dr. Podeszwa. Dr. Callan removed the tumor from Eman’s right leg, which removed a large segment of shin bone, including part of her tibia and fibula because both were damaged by the tumor. To close the large gap in her bone, Dr. Oishi performed what is called a free vascularized fibular transfer. He took the fibula, or small leg bone, from her left leg with its blood supply and transplanted it into the gap in her right leg. Drs. Podeszwa, Callan and Hubbard fixed the transplanted fibula into the remaining tibia to reconstruct a new leg using screws. After stabilizing the bone, Dr. Oishi connected the veins and arteries under a microscope. Dr. Oishi says that, over time, the fibula will hypertrophy, or remodel itself, to look like a new tibia.
“Wherever you put the fibula, it remodels itself to become the bone it replaces,” Dr. Oishi says. “If you put it in the femur, it grows to be a femur. If you put it in a tibia, it remodels to look like a tibia.” He clarifies that Eman will not need the portion of fibula in her left leg that was removed because enough was left to keep her ankle stable. To finish the procedure, Dr. Hubbard and Dr. Podeszwa applied an external fixator to Eman’s leg to stabilize the bone and help bear the weight of her leg as the bone heals.
“Eman’s condition is a very unique problem that required a large reconstruction and a team with the expertise of three subspecialties within orthopedics to make this happen,” Dr. Podeszwa says. “We are fortunate at Scottish Rite to have the people and the resources to offer these complex reconstructions that are fairly rare.” In addition to the surgical team and psychologist, Eman receives nursing, physical therapy and occupational therapy services at Scottish Rite.
After a successful surgery and months of recovery, Eman and her mom traveled to Canada for a summer vacation. Using her walker, Eman walked around in her fixator visiting her friends. “The external fixator is designed for Eman to walk and bear weight, which stimulates healing,” Dr. Podeszwa says. Eman will wear the fixator until her fibula gets thicker and stronger, like a new tibia, to support her full weight. “Eman is an amazing kid and a wonderful patient,” Dr. Podeszwa says. “She’s highly intelligent and highly motivated. Her attitude, outlook and engagement makes our job easier.”
“I’m so grateful that I have a team like the one I have at Scottish Rite,” Eman says. “I’m in awe of how much they’ve put into my care. They’ve shown me what it means to be a resilient and positive person. Scottish Rite has filled me with hope for what is to come.”
