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Prediction of Radial Head Subluxation and Dislocation in Patients with Multiple Hereditary Exostoses

Publication: The Journal of Bone and Joint Surgery     Year: 2021

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My Approach to Spinal Stenosis in Achondroplasia

As I treat individuals with Achondroplasia from around the world and of all ages, spinal stenosis with its inherent pain, weakness and eventual bladder and bowel dysfunction, is the most common complaint and reason for disability that I see. From an eight-year-old boy living in constant pain who could not sit to a 60 year old woman who can no longer walk in her house, spinal stenosis impacts all ages, in Achondroplasia. IT IS PREVENTABLE AND TREATABLE .

Yearly examinations and discussions of symptoms are required. If symptoms are occurring, even mild, an MRI will demonstrate the extent and location of the spinal compression. Surgery to decompress the stenosis to unroof the compression is often curative.

Fusion is necessary if the decompression requires removal of the joints or if there is kyphosis (hunch back) as often encountered in Achondroplasia. I often hear, "OH not a fusion- that is terrible". Completely untrue- when performed correctly and for the right indications, it allows the individuals to return to normal. It is not simple and recovery but it is often the only way to avoid ending up with a terrible spinal deformity after decompression. In order to enhance the fusion, I now do a minimally invasive side surgery at the same time at the lowest level to assure fusion, which is a problem when so much bone is removed to decompress. To decompress I utilize an ultrasonic scalpel which is more accurate, safer and involves much less blood loss.

Below is a questionnaire that we administer to all of our Achondroplastic patients and none of us at the Paley Institute would lengthen a patient until their spine is cleared.

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Novel Approach to Improving Knee Range of Motion in Arthrogryposis with a New Working Classification

Publication: MDPI     Year:2021

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Anatomic Relationship of the Femoral Neurovascular Bundle in Patients With Congenital Femoral Deficiency

Publication:Journal of Pediatric Orthopaedics     Year:2020

Congenital femoral deficiency (CFD) is a rare condition that affects the morphology of the hip and surrounding soft tissues. Bony deformity and distorted muscular anatomy are well known, but no studies have described the relationship of the femoral neurovascular (NV) bundle to surgically relevant anatomic landmarks. The authors compared the location of the femoral NV bundleontheaffectedsidein patientswithCFDwith theunaffected side.

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Legg-Calvé-Perthes Disease

ISBN: 978-1-0716-0852-4
Publication: Springer

Provides a comprehensive, evidence-based discussion of all aspects of LCPD, including assessment and treatment
Takes a well-balanced approach toward all treatment methods, including trends and controversies
Written by experts in the treatment of LCPD

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A Predictive Risk Index for 30-day Readmissions Following Surgical Treatment of Pediatric Scoliosis

Publication: Journal of Pediatric Orthopaedics     Year: 2016

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A Randomized Clinical Trial Comparing Intralesional Bone Marrow and Steroid Injections for Simple Bone Cysts

Publication: The Journal of Bone and Joint Surgery     Year: 2008

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Accuracy of Correction of Tibia Vara

Acute Versus Gradual Correction

Publication: Journal of Pediatric Orthopaedics     Year: 2006

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Articulated Hip Distraction

A Treatment Option for Femoral Head Avascular Necrosis in Adolescence

Publication: Journal of Pediatric Orthopaedics     Year: 2009

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Calculation of rotational deformity in pediatricsupracondylar humerus fractures

Publication: Skeletal Radiol     Year: 2007

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Costs and complications of increased length of stay followingadolescent idiopathic scoliosis surgery

Publication: Journal of Pediatric Orthopaedics B     Year: 2019

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Current Practice in the Management of SlippedCapital Femoral Epiphysis

Publication: Journal of Pediatric Orthopaedics     Year: 2016

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Distraction Osteogenesis of the Fibula to Correct Ankle Valgus in Multiple Hereditary Exostoses

Publication: Bulletin of the Hospital for Joint Diseases     Year: 2016

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Early complications encountered using a self-lengtheningintramedullary nail for the correction of limb length inequality

Publication: Joint Diseases & Related Surgery     Year: 2007

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Evaluation of an Algorithmic Approachto Pediatric Back Pain

Publication: Journal of Pediatric Orthopaedics     Year: 2006

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Interobserver and intraobserver reliability of radiographicevidence of bone healing at osteotomy sites

Publication: Journal of Pediatric Orthopaedics B     Year: 2006

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Interobserver and Intraobserver Reliability in Lower-Limb

Deformity Correction Measurements

Publication: Journal of Pediatric Orthopaedics     Year: 2007

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Intra-Articular Osteotomy for Genu Valgum in theKnee with a Lateral Compartment Deficiency

Publication: The Journal of Bone and Joint Surgery     Year: 2016

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Limited atlantooccipital and cervical range of motionin patients with familial dysautonomia

Publication: Journal of Pediatric Orthopaedics B     Year: 2011

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Femoral Deformity Correction in Children and Young AdultsUsing Taylor Spatial Frame

Publication: The Association of Bone and Joint Surgeons     Year: 2008

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Outcomes analysis after routine removal of implantsin healthy pediatric patients

Publication: Journal of Pediatric Orthopaedics B     Year: 2009

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Painful Flexible Flatfoot

Publication: Elsevier     Year: 2015

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Peripheral Arthropathy in Hereditary Sensory andAutonomic Neuropathy Types III and IV

Publication: Journal of Pediatric Orthopaedics     Year: 2009

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Not All Hip Dysplasias are the Same: Preoperative CTVersion Study and the Need for Reverse BernesePeriacetabular Osteotomy

Publication: Journal of Pediatric Orthopaedics     Year: 2015

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The Etiology of Cam-type FemoroacetabularImpingement: A Cadaveric Study

Publication: Journal of Pediatric Orthopaedics     Year: 2015

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Thoracic adolescent idiopathic scoliosis: selectionof fusion level

Publication: Journal of Pediatric Orthopaedics B     Year: 2010

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Wound Closure in Nonidiopathic Scoliosis:Does Closure Matter?

Publication: Journal of Pediatric Orthopaedics     Year: 2015

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Accuracy of Closed Reduction of Pediatric Supracondylar Humerus Fractures Is Training in Pediatric Orthopedic Surgery Necessary?

Publication: ResearchGate     Year: 2019

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Arthrogryposis

Calculation of Rotational Deformity in Pediatric Supracondylar Humerus Fractures”

Publication: Skeletal Radiology     Year: 2006

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Back Pain

Evaluation of an Algorithmic Approach to Pediatric Back Pain

Publication: Journal of Pediatric Orthopaedics     Year: 2006

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Bone Healing

Interobserver and Intraobserver Reliability of Radiographic Evidence of Bone Healing at Osteotomy Sites

Publication: Journal of Pediatric Orthopaedics Part B     Year: 2006

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Arthrodesis

Hip Arthrodesis in Adolescents Using External Fixation

Publication: Journal of Pediatric Orthopaedics     Year: 2001

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Scoliosis

A Predictive Risk Index for 30-day Readmissions Following Surgical Treatment of Pediatric Scoliosis

Publication: Journal of Pediatric Orthopaedics     Year: 2016

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Osteoarthritis

Osteoarthritis Associated with Osteopetrosis Treated by Resurfacing Arthroplasty

Publication: The French Journal of Orthopaedic Surgery     Year: 1991

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Congenital Dislocation

How To Avoid Missing Congenital Dislocation of the Hip

Publication: The Lancet     Year: 1999

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Dysplasia

Genu Valgum Secondary to Focal Fibrocartilaginous Dysplasia of the Distal Femur

Publication: Journal of Pediatric Orthopaedics     Year: 2004

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Managing Hip Dysplasia

Publication: Advance     Year: 2002

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Hip Fracture

Clinical Efficacy of Aspirin and Dextran for Thromboprophylaxis in Geriatric Hip Fracture Patients

Publication: Journal of Orthopaedic Trauma     Year: 1993

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Neurosurgery

Subfascial Implantation of Intrathecal Baclofen Pumps in Children Technical Note

Publication: Neurosurgery     Year: 2001

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Pediatric Orthopaedics

Use of the Foot Abduction Orthosis Following Ponseti Casts

Publication: Journal of Pediatric Orthopaedics     Year: 2005

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Employing The Kid Friendly Approach

Publication: OTR Practice Builder     Year: 2003

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The Use of Bone Scan to Investigate Back Pain in Children and Adolescents

Publication: Journal of Pediatric Orthopaedics     Year: 2000

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Clubfoot

A Method for the Early Evaluation of the Ponseti (Iowa) Technique for the Treatment of Idiopathic Clubfoot

Publication: Journal of Pediatric Orthopaedics Part B     Year: 2003

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Percutaneous Fixation in Clubfoot Surgery A Radiographic and Gait Study

Publication: Journal of Pediatric Orthopaedics Part B     Year: 2002

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Predicting the Need for Tenotomy in the Ponseti Method for Correction of Clubfeet

Publication: Journal of Pediatric Orthopaedics     Year: 2004

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Others

Calculation of Rotational Deformity in Pediatric Supracondylar Humerus Fractures”

Publication: Skeletal Radiology     Year: 2006

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Hinged Distraction of the Adolescent Arthritic Hip

Publication: Journal of Pediatric Orthopaedics     Year: 2005

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Management of Unstable Acute Slipped Capital Femoral Epiphysis Survey Results

Publication: Journal of Pediatric Orthopaedics     Year: 2005

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Correction of Tibia Vara With Six-Axis Deformity Analysis and the Taylor Spatial Frame

Publication: Journal of Pediatric Orthopaedics     Year: 2003

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Congenital Pseudoarthrosis of the Tibia

Publication: Journal of Pediatric Orthopaedics Part B     Year: 2000

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West Palm Beach Paley Institute
901 45th Street
Kimmel Building
West Palm Beach, FL 33401

New York, NY 30 E. 40th St.
Room 905
New York, NY 10016

Paley European Institute Medicover Hospital
Al. Rzeczpospolita 1
02-972 Warsaw Poland