Some of our patients have also allowed us to share the story of their treatment from a medical perspective. Rest assured that participation is voluntary and you can be certain that unless you grant us written permission to share your medical journey, all of your information will be kept private and confidential. To see the these treatments from the patients perspective, click here.
Shaunak first visited my office for an evaluation of his lower limbs a month before his sixth birthday. He’d been diagnosed at birth with achondroplasia, a bone growth disorder that causes a form of dwarfism. The condition is caused by a mutation in the FGFR3 growth gene that prevents growth cartilage in the limbs from ossifying into bone, resulting in insufficient bone growth and short stature.
I first met Douglas when his parents brought him in at the age of 1 week old for a consultation on his bilateral clubfeet. Douglas was a breached birth and was delivered via c-section. He had two siblings and no family history of clubfeet or hip disorders.
Vincenzo was a 14 year old boy from Bari, Italy who was diagnosed with arthrogryposis at birth and had been wheelchair bound since the age of six. His family had previously sought treatment in Altamura and Milano Italy but doctors had not provided any treatment and told the family that nothing could be done to improve his condition. Vincenzo had a burning desire to walk and wanted to have better control of and movement in his upper limbs. The family traveled to America for definitive care.
Avascular Necrosis of the Hip
David is an avid hiker who fell and landed on his hip during a hike. He continued to hike for 13 more miles and then sought treatment at a local emergency room where x-rays revealed a left femoral neck fracture. He was transferred to a children’s hospital where he underwent an open reduction and internal fixation (ORIF) procedure on his left femur to fix the femoral neck fracture and an aspiration of the left hip due to an accumulation of blood.
Following the birth of her second child, Nadine began experiencing pain in her groin that was intermittent but would become worse with prolonged activities. After six years, the pain began to worsen and ascending stairs became especially painful. Following several months of this increased pain she visited a doctor and an MRI revealed a cartilage (labral) tear in her right hip. Surgery was recommended but Nadine chose physical therapy instead which actually worsened her symptoms.
I first examined Anthony when he was four years old, shortly after he had been diagnosed with bilateral Legg-Calve-Perthes disease. Anthony’s hips had limited range of motion and his left hip had 20 degrees less abduction than his right. Attempts at full abduction or internal rotation would result in pain. His left hip involved the entire femoral head while the right hip was less severely involved. I placed him on Naprosyn 250mg to be taken twice daily which provided good pain relief and greater ease during his physical therapy sessions.
A pain in the leg around the age of 8 led to Bernard being diagnosed with Legg-Calve-Perthes disease. Review of an intraoperative arthrogram determined that the best course of treatment was arthrodiastasis with an EBI fixator applied to the hip. Since being treated, Bernard no longer experiences any pain is his hip and has returned to his normal activities with no limitations.
Lower Limb Deformity
Charlotte has been my patient since she was three years old. Over the years, I’ve collaborated with other medical professionals to treat her for various issues with her right leg. Her issues began with a hemangioma that involved her entire right tibia. The hemangioma damaged her knee, ankle, and foot joints in addition to her growth plates which inhibited the growth of new bone. After several minimally invasive procedures, the hemangioma was finally stabilized when she was eight years old.
Francesca is a competitive level female gymnast who sustained a proximal tibia fracture at the age of 10 after falling off a balance beam and landing incorrectly on her right leg. She was treated at a local emergency room at which point she was sedated and her leg was manipulated into position and placed in a long leg cast for eight weeks. After her cast was removed, she received physical therapy for strengthening for approximately six weeks.
Miscellaneous Orthopedic Conditions
At the age of 23, Christopher a young man with left hemiplegic cerebral palsy visited me for an evaluation of right knee pain which began eight years prior without any known injury. Christopher was unable to walk independently, had a history of lower limb issues, and had undergone several surgeries prior to and after the occurrence of his knee pain. I found that a combination of a crouched gait, hip contracture, and knee contractures were causing his knee pain. A series of tenotomies, osteotomies, and a trochlear replacement relieved his pain and improved his ability to walk.
Jordan was born with skeletal issues which included low muscle tone, absent clavicles, and congenital kyphosis. He was later diagnosed with cleidocranial dysostosis, a rare hereditary congenital disorder which causes teeth and bones in the upper torso to develop abnormally. At the age of 13, Jordan’s spine had developed multiple hemivertebrae in addition to scoliosis and kyphosis curves. Jordan underwent a posterior spinal fusion with Ponte osteotomies to help straighten his spine and expand his ribs. He did very well after surgery and was able to return to playing basketball five months after surgery.
Nathalie was diagnosed with osteogenesis imperfecta (Type IV) as a toddler. Osteogenesis imperfecta is a congenital genetic condition that causes brittle bones which fracture easily from minor impact and in some cases for no reason. Given the nature of osteogenesis imperfecta, childhood fractures are to be expected and require immediate attention to avoid long-term issues. Nathalie is now in her early teens and doing very well.
A few days before her sixth birthday, Ashley visited my office for a second opinion on her spine. Ashley’s mother first noticed a curve in her spine a year before and her pediatrician referred them to orthopedic doctors for further evaluation. MRIs and x-rays showed a 30 degree curve in her spine (scoliosis) along with a vertebra that was undeveloped on one side (hemivertebra). There was no family history of either scoliosis or kyphosis. Given the combination of spinal issues, her doctors reached a consensus that surgical intervention was needed.
At the age of six, Stephanie was diagnosed with scoliosis. At the age of nine, a brief attempt was made to treat her curve with a brace but it was too uncomfortable for her to wear. A few months before her 12th birthday, her pediatrician advised that a spinal fusion was the best course of action.
Varus Ankle and Medial Physeal Bar
At the age of 10, Grace dislocated and fractured her right ankle during gymnastics. She underwent surgery at another facility to repair the injury which had also affected her growth plate (physis) and heel. After surgery, she was placed in short leg casts for six weeks, made a full recovery, and was able to return to gymnastics.