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On The Move: Unstoppable

On The Move: Unstoppable

by | Sep 26, 2022 | Hand Conditions

Article previously published in Rite Up, 2022 – Issue 2.

It is not uncommon to see Michael, of Redmond, Washington, posing like his favorite superheroes. He loves playing Minecraft™, riding his bike, swimming, wearing costumes, acting, dancing and singing. In January 2021, this highly active and vivacious young man had a life-changing surgery performed on his left forearm by pediatric orthopedic experts from our hand and limb lengthening and reconstruction teams at Scottish Rite for Children.

“I have no words to describe the blessing it has been for Michael and myself,” Berenice, Michael’s mother, says. “Scottish Rite is simply amazing.”

Michael was born premature at 23 weeks and stayed in the NICU for four months. At 3-months-old, the family realized he had a bump on his left arm and worked with Michael’s doctors to investigate the issue. Following a biopsy, it was determined that Michael had congenital pseudoarthrosis, which caused a deformity in the bones in his left forearm.There are very few teams that could successfully manage the complexities and intricacies of Michael’s treatment, but Scottish Rite for Children could. “To me Scottish Rite is a place where miracles happen, where the prayers of many parents come true,” Berenice says. “The doctors really care, and all the staff understand you and want to help in any way they can. Somehow you know your child is in the best hands, and you trust they are going to be okay.”

 

Watch Michael’s Story and learn more about Scottish Rite’s extraordinary care.

Read the enitre issue.

5 Common Questions About Limb Lengthening

5 Common Questions About Limb Lengthening

by | Apr 6, 2022 | Limb Lengthening

At Scottish Rite for Children, the Center for Excellence in Limb Lengthening and Reconstruction includes a multidisciplinary team of experts who collaborate to determine the best treatment plan for each patient. We know there are a lot of questions if your child begins treatment for their limb length discrepancy. Below are the most commonly asked and the answers from our team. 

Do I Have to Have Surgery?

If the difference between the lengths of your limbs is significant (more than 1 inch), surgery may help to prevent problems in the future. For small limb length differences (1-2 inches), sometimes a small surgery (an epiphysiodesis) that slows down the growth of the long leg and allows the shorter leg to grow and catch up is all that is needed. For bigger limb length differences, lengthening the short leg is needed. There are different techniques for lengthening a leg, including lengthening rods that are placed inside the bone or an external fixator, an advanced device developed at Scottish Rite for Children that is around your leg and attached to your bone. The type of device used is frequently determined by the cause of your leg length difference. The Limb Lengthening and Reconstruction team will explain the best technique for you. Both techniques lengthen the bone very slowly over several weeks. 

How Does the Limb-Lengthening Device Work?

When using the lengthening rod, the doctors separate the bone in your shorter limb and insert the rod inside the bone. The rod will be secured to the bone at each end of the rod. After surgery, you will use a device that rests on your leg to activate the rod to slowly lengthen and separate the bone a little bit each day.  

The external fixator, the TL Hex External Fixator System, has rods that are attached to each side of the separated bone. These rods are connected to rings attached to the outside of your limb. Every day, you will turn struts that connect the rings and cause the rings and the bone to slowly separate and lengthen. The frame will support your limb while the rods help the bone to grow. 

Will Limb Lengthening Hurt?

During surgery, you’ll be under anesthesia, so you won’t feel a thing. Whether you use the lengthening rod inside the bone or the external fixator, there is soreness as the bone and muscles lengthen. Your doctor will be able to give you medication to minimize the pain. In addition, Scottish Rite for Children has pediatric psychologists who will teach you other ways to manage your pain.

How Long Will Lengthening Take?

The amount of time you will need to wear the frame will be determined by how much your limb needs to grow. Regardless of the technique, for most patients, it takes six to nine months from the time of surgery to the time you are back to running and jumping. Most of the bone lengthening actually takes place in the first few months. After that, it takes time for the bone to fully heal and for you to get your full strength back.

When Can I Return To My Normal Activities?

After you spend a little time healing from your surgery, getting back to as normal a routine as possible is really important. Lengthening your leg and doing your daily exercises becomes part of your regular day. You will go back to school and participate in many of your typical activities. If you have a lengthening rod, you will not be able to put all of your weight on the leg being lengthened and will have to use crutches until the bone is almost completely healed. If you have an external fixator, the frame will support your whole body weight and after a few weeks you won’t need crutches. While you are lengthening your leg, you will visit the doctor every week, but once the lengthening is completed, you will only need to visit monthly.

Limb Reconstruction Meeting Brings Experts from Around the World to Dallas

Limb Reconstruction Meeting Brings Experts from Around the World to Dallas

by | Feb 7, 2020 | Research & Innovation

Scottish Rite Hospital is honored to host the second annual Controversies in Pediatric Limb Reconstruction (CPLR). This two-day seminar brings together leaders in the field to collaborate and discuss the latest treatment techniques for pediatric patients with limb deformities, limb loss, musculoskeletal infection and severe length discrepancies. 

In conjunction with the Limb Lengthening and Reconstruction Society (LLRS) and the Pediatric Orthopaedic Society of North America (POSNA), the program includes lectures, panel discussions and case studies presented by hospital staff and international guests. Co-directed by pediatric orthopedic surgeon David A. Podeszwa, M.D., and researcher Mikhail Samchukov, M.D., CPLR serves as a unique opportunity to bring together experts from various backgrounds who provide care to this specific patient population.

As a leader in this specialty, the Center for Excellence in Limb Lengthening team travels the world to teach others about the devices used to treat conditions associated with limb deformities. CPLR cultivates local and international collaboration right here in Dallas, TX. 

“We are excited to host this prestigious event,” says Podeszwa. “We have the opportunity to collaborate with some of the best from around the world, right here in our hospital, to advance the care provided to these patients. CPLR gives attendees a focused and comprehensive program where they are able to learn, debate and discuss the latest treatment techniques – with the hopes that they take that knowledge and apply it at their respective institutions worldwide.”

Learn more about our Center for Excellence in Limb Lengthening.  

#SRHaccess Facebook LIVE Recap: Limb Lengthening – Intramedullary Lengthening

by | Aug 17, 2018 | Limb Lengthening

On this week’s Facebook live, Co-director of the Center for Excellence in Limb Lengthening David A. Podeszwa, M.D. joined us to discuss intramedullary lengthening – a form of treatment for our limb lengthening and reconstruction patients.

 the Facebook live.

Watch –What is intramedullary lengthening and how does it work?

  • It is a technique of lengthening the bone that uses a rod that is surgically planted inside the bone, lengthening it over time using a magnet or an electrical current.

When is intramedullary lengthening used as a treatment plan?

  • Ideal for patients who have a leg-length discrepancy over 4 or 5 centimeters at the time that they’re done growing.
  • Intramedullary technique works better in patients who have straight bones

What’s the difference between the external fixators and intramedullary rods?

  • Usually, an intramedullary rod is preferred over an external fixator.
    • Quality of life is better for patients with intramedullary rods.
    • Less pain for the patient, and less care required with intramedullary rods.

Different types of intramedullary rods:

  • Magnetic rod – a magnet slowly lengthens the rod inside the bone
  • Electrical current – a small transducer sends an electrical current that slowly lengthens the rod.

How long do patients stay in the hospital after one of these rods is implanted?

  • A majority of the time the rod goes in and the patient will go home the next day.
    • We wait anywhere from 5-14 days after the rod goes in before we start lengthening process in clinic.

How long does the lengthening process take?

  • It’s going to be at least between six and nine months.
    • The bone will lengthen about a millimeter a day, and every centimeter of lengthening requires about a month of healing.

Multidisciplinary approach:

  • A child whose limb length difference is over two inches requires a team of experts to guide the patient and their family through the six- to nine-month process.
  • Working as a team: before a surgery date is set, the patient and their family meet with multiple departments within the hospital.
    • Physicians meet with fellow physicians to discuss the treatment plan.
    • Patient meets with the nursing team to discuss education regarding the procedure and what to expect.
    • Our psychology team meets with the patient and family to help them understand the treatment and how to cope with the before and after stages.

At what age our patients a candidate for an intramedullary rod?

  • Patients become candidates when they are 8, 9 or 10 years old, depending on the deformity.
    • In most cases, it is best to wait until the patient is done growing.

What’s the activity level allowed during this process?

  • Once the lengthening process begins, the patient will be on crutches until the lengthening process is complete and the bone has healed enough to walk on it again.
    • Between the daily physical therapy and the extended time on crutches, the patient is the most important part of the lengthening process.

Final thoughts about limb lengthening:

  • As the technology improves, it will open a lot of doors for patients.
  • In the end, treating the difference is to improve the patient’s life, but not define their childhood.

Our experts are here for the patient and their family every step of the way.  Have more questions about limb lengthening?  Email askadoc@tsrh.org.

Learn more about limb lengthening and the research our hospital is conducting.

Dallas Hospitals Collaborate for Annual Research Conference

Dallas Hospitals Collaborate for Annual Research Conference

by | Dec 1, 2017 | Research & Innovation

Texas Scottish Rite Hospital for Children is hosting the 2017 Clinical Research Conference: Building Clinical Research. This collaborative one-day meeting brings together research professionals from various institutions around the Dallas area, including Scottish Rite Hospital, Children’s Health, the University of Texas Southwestern Medical Center and Parkland Memorial Hospital.

Various staff from each institution have been invited to give presentations on their area of expertise. The annual conference allows clinicians and researchers to learn from one another on the importance of utilizing research to improve patient care, innovation regarding study design and working through the difficulties of multidisciplinary research studies.  

Scottish Rite Hospital’s Director of Clinical Research Adriana De La Rocha, Ph.D., CCRP and Assistant Administrator of Research Matt Ferguson, recognize the value of providing an educational event for the staff and fellow research professionals in the area. “The annual research conference gives the hospital the opportunity to network and collaborate within the research community,” says De La Rocha. “As an institution, we are honored to work with Children’s Health to host this meeting to bring more education and awareness on the type of clinical research projects we collaborate with our medical staff and learn how we may improve the care we give our patients.” 

This year, Assistant Chief of Staff Emeritus John G. Birch, M.D. is among one of the conference speakers. As a key member to the hospital’s Center for Excellence in Limb Lengthening team, Birch is presenting on the evolution of leg lengthening and reconstruction within the pediatric population and the future of the treatment. 

Scottish Rite Hospital is honored to host such an influential conference to facilitate collaboration between four prestigious institutions. This opportunity allows the hospital to continue its mission of education, research and world-renowned patient care.