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.  

Scottish Rite Hospital Hosts Prestigious Hand Conference

Scottish Rite Hospital Hosts Prestigious Hand Conference

by | Oct 11, 2019 | Research & Innovation

Scottish Rite Hospital’s Charles E. Seay, Jr. Center for Excellence in Hand Disorders is committed to caring for children with hand and upper limb conditions. The center is focused on providing innovative treatment to help patients live active and independent lives. In addition, the hospital’s hand team has become the leader in training hand surgeons from across the globe.

This week, the hospital is hosting the Marybeth Ezaki/Peter Carter Visiting Professorship. Established in 2017, this two-day conference brings together pediatric upper extremity surgeons, as well as other orthopedic surgeons, to discuss the latest treatment techniques in caring for children with complex hand conditions. The visiting professorship is in honor of Marybeth Ezaki and Peter Carter, both former staff hand surgeons who provided world-renowned care and innovation during their time at the hospital.

The hospital is welcoming Steve E.R. Hovius, M.D. – a certified plastic and hand surgeon from Radboud University Medical Centre Nijmegen and at the Xpert Clinic Hand and Wrist Centre Rotterdam. He brings decades of experience, serving as the head of the department of Plastic and Reconstructive Surgery and Hand Surgery at the Erasmus University Medical Centre Rotterdam. The meeting also includes presentations and discussions from hospital staff.

Director of the hand center and co-director for this program Scott Oishi, M.D., FACS, is proud to host such a prestigious group. “Treating pediatric hand conditions can be tricky,” says Oishi. “It requires a specialized team who is dedicated to learning and advancing their techniques. This program is unique in that it brings together hand specialists, both near and far, to discuss the care and treatment of a pediatric hand patient and collaborate on current research.”

Learn more about the hospital’s Center for Excellence in Hand Disorders.

Hospital Doctors Lead the Research and Education in Children with Clubfeet

Hospital Doctors Lead the Research and Education in Children with Clubfeet

by | May 31, 2019 | Research & Innovation

At Scottish Rite Hospital, we are dedicated to providing world-renowned patient care. Our team of experts are able to do so through their steadfast commitment to advancing treatment through research and education. The hospital’s physicians and clinical staff are known worldwide for the research conducted in our Center for Excellence in Foot.

Clubfoot is one of the most common pediatric foot conditions that our experts treat. Through research, our team can study this patient population to better understand the condition and develop innovative treatment plans. With voluntary participation from patients, the team is able to review outcomes after treatment and assess how a child with clubfeet is functioning.

Recently, the hospital published two articles on their latest clubfoot research. Below is what our team is learning:

Functional Outcomes of Patient with Clubfeet at 10-year Follow-up
This research was led by Assistant Chief of Staff Lori A. Karol, M.D., Movement Science Manager Kelly Jeans, M.S., and other staff from the Movement Science Lab.

Summary

Our team analyzed outcomes of patients’ feet who received either the Ponseti serial casting (a form of treatment that places a cast from the thigh to the toes after gentle stretching of the foot) or French physiotherapy (daily stretching, exercise and massage, and taping to slowing move the foot to the correct position), and those who later required subsequent surgery. The Movement Science Lab recorded gait analysis, ankle strength, daily step activity and parent-reported outcomes of patients 10 years after receiving treatment.

What We Learned

  1. Children with clubfeet have less range of motion, movement and power in their ankle in comparison to children with normal feet.
  2. There are minimal differences in gait, parent-reported outcomes and daily activity between feet treated with Ponseti casting or physical therapy.
  3. Feet that did not receive surgery had better ankle power and muscle strength than feet requiring invasive joint surgery.

Clinical Significance

This study supports our efforts to minimize invasive joint surgery when treating a patient with clubfoot. Functional studies such as this continue to help our doctors in developing treatment plans for patients diagnosed with clubfoot.

Read the full article

Non-operative Treatment Outcomes for Patient with Non-Idiopathic Clubfeet
This research was led by Chief Medical Officer B. Stephens “Steve” Richards, M.D., and nurse practitioner Shawne Faulks, M.S.N., R.N., C.N.S.

Summary

Our doctors regularly diagnose and begin treating clubfoot during infancy. Since much of the non-operative treatment takes place before developmental milestones, some patients who were initially thought to have “idiopathic” (no known cause) clubfoot may develop other conditions throughout development rendering a “non-idiopathic” diagnosis. Little is known about the treatment outcomes of this population. Therefore, the purpose of this research is to better understand the clinical outcomes of patients who were later found to have non-idiopathic clubfoot, and how their outcomes compare to patients who have idiopathic clubfoot.

What We Learned

  1. Nearly 1 in 10 infants with idiopathic clubfoot were found to later have non-idiopathic clubfoot due to other orthopedic, neurological or developmental disorders.
  2. Non-idiopathic patients can be expected to respond favorably to non-operative treatment.
  3. Patients later found to be non-idiopathic had a greater chance for clubfoot recurrence that required surgery.

Clinical Significance

This study demonstrates the importance of developmental assessments during a child’s clinical visit. Pediatric orthopedic specialists should be proactive in evaluating more than just clubfeet or other orthopedic disorders during follow-up exams.

Read the full article

Learn more about the research in our Center for Excellence in Foot.

McIntosh and Tulchin-Francis Receive the Women Who STEAM Award

McIntosh and Tulchin-Francis Receive the Women Who STEAM Award

by | May 3, 2019 | Research & Innovation

At Scottish Rite Hospital, our team of experts are recognized nationally and internationally for their dedication to advancing the care for children with orthopedic conditions. This week, two of the hospital’s very own received a unique honor.

Pediatric orthopedic surgeon Amy L. McIntosh, M.D., and Division Director of Movement Science Kirsten Tulchin-Francis, Ph.D., were selected as Women Who STEAM by the Dallas Chapter of The Links, Incorporated. The STEAM award acknowledges outstanding women from diverse backgrounds in the areas of science, technology, engineering, arts and math. McIntosh, Tulchin-Francis and the other six women honored, have made remarkable contributions in their respective fields, while also teaching, mentoring and serving within the community and workplace.

McIntosh and Tulchin-Francis are leaders and innovators at the hospital. Both understand the importance of educating the next generation, especially young women who may be interested in the sciences. Together, they organize and host the Dallas Perry Outreach Program and Medical Student Outreach Program through The Perry Initiative – an organization that encourages young women to pursue careers in orthopedic surgery and engineering. They have the opportunity to share their story to this group and showcase what it is like to be a female working in this industry. “The greatest honor is to have the opportunity to influence young girls,” says Tulchin-Francis. “Being able to show them what I do and letting them take what they are learning in the classroom and see how it can be applied in real life is a victory in itself.”

The Links, Incorporated is an international, not-for-profit corporation established in 1946 that consists of over 15,000 professional women of color located throughout the world. The 2019 inaugural Women Who STEAM Award luncheon was hosted by the corporation’s Dallas chapter. They recognize the tremendous value in actively supporting the growth and development of young girls to create a positive future for the community. The chapter established the Women Who STEAM Award to create a pipeline to success for all girls of color, specifically in the STEAM fields.

(Photos courtesy of Reflections HP Photography, ReflectionsHD.com)

Pediatric Foot Disorders: What Are We Learning From Research?

Pediatric Foot Disorders: What Are We Learning From Research?

by | May 2, 2019 | Research & Innovation

Scottish Rite for Children Center for Excellence in Foot includes a multidisciplinary team that is dedicated to advancing the treatment for complex pediatric foot conditions. Directed by Anthony I Riccio, M.D., the center conducts comprehensive research into clubfoot – a congenital disorder in which the child’s foot is severely turned inward and pointed downward. In addition, Dr. Riccio leads the research for complex adolescent foot disorders. Alongside an adult foot and ankle surgeon, Riccio works with a diverse group of specialists to analyze these cases and conducts research to advance how the disorders are treated. 

Prospective Evaluation of Treatment for Clubfoot
Purpose:  To help orthopedic surgeons better understand and treat patients with a diagnosis of clubfoot.  

The research team is collecting data from hospital patients who volunteer to participate in the study. The team is currently evaluating the immediate and long-term outcomes of patients who undergo surgical and non-surgical treatment interventions. Participants are followed until skeletal maturity and are asked to participate in questionnaires, motor and strength tests, gait analyses and pedobarographs (a device that measures foot pressure abnormalities) along the way. Currently, there are over 1,500 patients enrolled in the study. This research will establish a protocol for the collection of relevant clinical and functional outcome measures on our patients with a diagnosis of clubfoot.

The Foot and Ankle Registry
Purpose: To further the understanding of the functional and long-term outcomes of adolescents treated for a foot and/or ankle deformity by creating a prospective registry for patients treated at the hospital.

The research team is currently collecting data on adolescent patients who visit the hospital for any form of foot or ankle deformity. Currently, there are about 300 patients enrolled. Some of the deformities include bunions, flat feet, coalitions and several others of varying severity. If eligible, patients are invited to voluntarily participate in the study activities. These include:

  • Questionnaires
  • Clinical photos in the media department
  • X-rays
  • Gait analysis in the movement science lab 

The data collected will provide the research team the opportunity to evaluate the immediate and long-term clinical, functional and radiographic outcomes of this understudied patient population. By doing this, the foot and ankle experts hope to better define the treatment methods for the varying foot and ankle diagnoses throughout the hospital.

Redefining the Juvenile Bunion
Purpose: To understand the formation of juvenile bunions and if experts should treat them differently from the adult deformity. 

This was a study using the questionnaires, X-rays and pedobarographic data from 32 bunion patients in the Foot and Ankle Registry. The study team collected data from the X-rays through measurements of different angles associated with the foot and correlated them to the completed questionnaires from patients and performance during the pedopbarograph. The study team found that greater angles correlated with skewed pressure distribution of the foot resulting in higher pain and less functionality. Overall, this study will open the door to many more comparative projects to assess the best method of treating juvenile bunions.

Learn more about the research being conducted in the Center for Excellence in Foot.

Doctors Travel to Israel for International Pediatric Orthopedic Conference

Doctors Travel to Israel for International Pediatric Orthopedic Conference

by | Apr 5, 2019 | Research & Innovation

Doctors from the hospital are attending the 38th annual European Paediatric Orthopaedic Society (EPOS) meeting in Tel Aviv, Israel. EPOS is an international association comprised of over 500 surgeons from across the world. This four-day conference allows members to discuss research and collaborate on latest treatment techniques to ultimately advance the quality of care for children with orthopedic conditions.

As active members of EPOS, hospital staff attend and participate throughout this international meeting each year. Several are in attendance, along with past fellows, presenting the hospital’s original research. Below are the projects being presented:

  • Can real time monitoring with a controlled advancement drill decrease plunge depth?
  • Metaphyseal fracture displacement is predictive of intra-articular diastasis in adolescent triplane ankle fractures
  • Gait analysis in children with proximal femoral focal deficiency

In addition to these research presentations, surgeons from Scottish Rite Hospital are directing the first ever web-based joint educational endeavor between EPOS and the Pediatric Orthopaedic Society of North America (POSNA). During this symposium, entitled “Across the Pond: International Differences in Pediatric Orthopaedic Trauma Management,” staff and former fellows from the hospital will discuss and debate current trauma treatment strategies with a panel of European trauma specialists. The debate will be recorded at the EPOS meeting and broadcast worldwide.

Pediatric orthopedic surgeon and director of resident education Anthony I. Riccio, M.D., is one of the hospital’s key representatives for EPOS. “As doctors and leaders within pediatric orthopedics, we have a responsibility to conduct research in order to better understand and find innovative techniques for treating complex conditions,” says Riccio. “It is an honor to travel the world to share our expertise and have the opportunity to both educate and learn from other specialists. Not only does this advance how we care for our patients here in Texas, but it evolves the treatment for pediatric orthopedic patients across the globe.”

Learn more about the hospital’s research.