Rutgers Medical School Department of Orthopedics Grand Rounds
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.