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5 Common Questions About Limb Lengthening

If your limbs aren’t the same length, you can experience problems as you grow. In some cases, doctors can use a limb-lengthening device to even your limbs out, making it easier for you to life an active, healthy life. If you’re curious about what limb lengthening involves and how it will affect your day-to-day life, you’ll find the answers you’re looking for here.

Do I Have to Have Surgery?

If the difference between the lengths of your limbs is significant (more than 1 inch), you may need surgery to correct the condition. At Texas Scottish Rite Hospital for Children (TSRHC), physicians have developed an advanced device called the TRUE/LOK™ External Fixation System, a modification of the Ilizarov Frame, that helps your limb grow over a number of months. This device is attached to your body during surgery.

How Does the Limb-Lengthening Device Work?

During surgery, doctors separate the bone in your shorter limb. The TRUE/LOK™ External Fixation System has rods that are attached to this part of the bone. These rods are connected to an external frame attached to the outside of your limb. The frame will support your limb while the rods help the bone to grow. Over the course of many months, your limb could be lengthened by up to 6 inches!

Limb Lengthening

Will Limb Lengthening Hurt?

During surgery, you’ll be under anesthesia, so you won’t feel a thing. As you wear the frame, however, you may experience some discomfort. Some patients feel soreness when they have to turn the rods to help their bones lengthen. Your doctor may be able to give you medication to minimize the pain. In addition, TSRHC has psychologists who can teach you other ways to manage your pain.

How Long Will I Wear the Frame?

The amount of time you will need to wear the frame will be determined by how much your limb needs to grow. For most patients, the TRUE/LOK™ only needs to be worn for six to nine months. During that time, you’ll turn the rods several times per day to help the bone in your limb grow. Most of the bone lengthening actually takes place in the first few months. After that, the frame is worn for stability as your bones heal into place.

Can I Still Act Like a Normal Kid?

After you spend a little time healing from your surgery, you can go back to school. You can also participate in your favorite activities while you wear the frame, including most sports. You can even go swimming as long as you swim in a salinated or chlorinated pool. Your wardrobe may need to be adjusted to include pants, shorts, or skirts that fit over your TRUE/LOK™ frame. Because you’ll only have to visit the doctor every couple of weeks, you’ll essentially be able to keep up your regular routine.

Think of limb lengthening like wearing braces on your teeth. It causes a little discomfort at the time, but it’s worth it in the long run.. You’ll be in great hands when you have your limb lengthening done by the experts at TSRHC.

My First Summer Volunteering

This year we had more than 200 Junior Volunteers spend their summers serving at the hospital. We couldn’t do all the great work we do here at the hospital without our volunteers, and we always enjoy the summers when some of our younger volunteers can help out and learn more about the hospital.  Fourteen year old Nitin of Frisco, was one of our Junior Volunteers this summer and shared his experience about volunteering.


Gharpure, Nitin, Nasni, Veda

“Texas Scottish Rite Hospital is very unique. Instead of simply treating a patient’s physical condition, TSRHC treats the patient’s emotional and mental sides as well. A hospital must care for a child as a whole, in order to make the child whole again. TSRHC does this perfectly. Even before receiving treatment, children walk through brightly colored rooms and hallways with fun paintings and the smell of popcorn in the air. Kids play games with volunteers and the entire atmosphere makes them feel like they are in a place that helps them, not a place where they are sick. This is what first got me interested in volunteering at Scottish Rite Hospital.

This summer, I had two placements – the art cart and purchasing/ receiving. Both of those placements opened my eyes to two vastly different, but integral parts of the hospital. Pulling around the art cart, I was able to play games with the kids in the waiting room and help make them feel more at home. This contributed to the fun atmosphere in TSRHC. It helped me feel like I was making a small difference in someone’s life by helping make their hospital stay more enjoyable.

Additionally, I worked in the more technical side of Scottish Rite Hospital in the purchasing and receiving department. There, I was able to deliver packages to many of the different parts of the hospital. My favorite part of this experience was being able to experience all the different locations within the hospital. This job helped me see how all of the departments work together to keep the hospital running smoothly.

Overall, volunteering at Texas Scottish Rite Hospital was a valuable experience. It gave me insight into the amount of behind-the-scenes work it takes to run a truly successful and effective hospital, and it enabled me to make friends, help people and make a small difference. I had a lot of fun volunteering and I’m looking forward to doing it again next year!”

– Nitin

ACL Reconstruction for Very Young Athletes – TSRHC Sports Medicine

At one time, orthopedic surgeons believed that waiting for surgery until an athlete was fully-grown was ideal for kids who had torn their anterior cruciate ligament (ACL). Henry Ellis, M.D. and Philip Wilson, M.D. have extensively studied the effects of waiting to reconstruct a torn ACL. They have found it’s not always best for some patients. Without a healthy ACL, one of the primary stabilizers for the knee, other tissues inside the joint are at risk for damage.

footballTo determine the right course of care for a very young athlete, our first step is to estimate the number of years of growth left in the knee joint. We do this by looking at the growth plates in an x-ray of the hand to determine the patient’s “bone age.” Only with the “bone age” can, the best treatment plan can be put in place for optimal outcomes.

Scott, now 13 years old, had his ACL reconstructed by Dr. Ellis, a TSRHC pediatric orthopedic surgeon, when he was 10. In athletes like him, with several years left to grow, the surgeon must carefully protect the growth plates. This way, the knee is stabilized, but the legs can continue to grow normally. If adult procedures are incorrectly used on young knees, the legs may end up different lengths or the injured leg may become bowed.

Now, Scott is back in action on the football field with no complaints and no concerns.  Good luck to Scott and the Bulldogs!

To learn more about growth plates, check out Dr. Ellis’ comments in an earlier post, “Have you ever thought about how bones grow?”

For information about pediatric sports medicine and surgical options, please visit our website at

Things to Know About Scoliosis Screening

As kids go back to school, many of them are being screened for scoliosis. Here is some information that you should know about the process:

  • What is Scoliosis? Scoliosis is a progressive condition causing the spine to curve or twist into a “C” or “S” shape.
  • What Causes Scoliosis? The most common form of scoliosis is idiopathic, meaning there is no known cause. Despite some popular beliefs, scoliosis does not result from carrying heavy items, athletic activity, sleeping/standing postures, or minor lower limb length discrepancies. Researchers at TSRHC identified the first genes associated with idiopathic scoliosis and hope the discovery will one day lead to identifying the cause of the spinal curvature
  • How is it diagnosed? Scoliosis usually occurs in early adolescence (5th – 9th grade), becoming more noticeable during a growth spurt. The child’s physician or school nurse will screen for scoliosis by having the child perform the Adam’s Forward Bend Test to look for any unevenness or abnormalities in the shoulders, ribcage or back. They can also screen using a device called the scoliometer or by taking an X-Ray.
  • Treatment: If your child has been told they have a curvature in the spine, their physician or school nurse can refer them to a healthcare provider such as Texas Scottish Rite Hospital for Children. From there, the physician will find the proper treatment method for your child.
    • Note: Approximately 5% of the patients referred to TSRHC will need treatment:
      • 3% – need surgery
      • 2% – need a brace
      • 45% – need observation
      • 50% – are determined not to have scoliosis and are released from care

Watch the following video from our Assistant Chief of Staff Dr. Karl Rathjen:

Patient Shares Lessons Learned in Moving Speech About “Happiness”

What is happiness? TSRHC patient Anika, age 18, of Lewisville, has been winning awards for her thought provoking take on the subject.

Screen Shot 2015-08-19 at 11.12.41 AMIn the latest triumph for her dramatic speech, “Happy,” the Lewisville High School senior competed in the National Speech and Debate Association’s annual National Tournament that was held in Dallas this summer. Anika was one of only two North Texas students to qualify in the Original Oratory category.

Earlier this year, she delivered the speech, which cites studies and other published observations about happiness, to TSRHC’s orthopedic staff.

Six years ago, Anika moved with her family from Bangladesh “for a better life,” she says, including medical care at TSRHC. She has cerebral palsy and has been treated at the hospital for related orthopedic conditions. The speech begins with Anika’s observation that from birth, the people closest to us “are blessing our futures with happiness and prosperity.” But what shape does that happiness take? She ponders whether what makes us happy is success, money, the latest technology and other “new ways of living easy” or a deeper inner satisfaction.

Anika’s own sense of happiness was shaken by a personal tragedy she outlines in the speech. “Step back, smell the roses, hug a little,” she says in closing. “And remember, it’s never too late to be happy.”


Triathlons for young athletes: Three times the fun – TSRHC Sports Medicine

Did you know that triathlons were “born” in the United States in the 1970’s? This relatively new phenomenon in sports has evolved to attract younger and younger athletes over the years.

UntitledThirteen year-old Caitlin, a prior patient of Shane Miller, M.D. and multi-sport athlete, is gearing up for her third triathlon. She certainly won’t be the youngest at the upcoming North Texas Kids Triathlon in Arlington. The event will include athletes as young as five years old.

With athletes this young competing, it’s good to know the medical team of Texas Scottish Rite Hospital for Children sports medicine experts, led by Dr. Miller, have already begun discussing race-day logistics and confirming safety plans for young athletes, like Caitlin.

Next to safety for the athletes, Dr. Miller says the top priority for kids participating in distance events, like The North Texas Kids Triathlon, is for them to have fun. Caitlin tells us, this event meets the mark. From the pre-event pep rally to the post event celebration, there is no shortage of fun. The September 20th event co-presented by Texas Scottish Rite Hospital for Children Sports Medicine and Academy Sports is sure to be a great day.

Good luck to all the young triathletes!

If your young athlete is interested in participating, find more information and register here.

For information about TSRHC’s Center for Excellence in Sports Medicine, please visit our website at

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Celebrating the Gift of Gratitude – TSRHC Celebrates 20 Years of Treasure Street

TSRHC’s signature event was started 20 years ago by a family with one goal – giving back.

On a crisp spring evening in 1996, Dallas residents Dee and Dodge Carter gathered close friends and family around their dining table with a mission in mind. They were exploring ways to give back to TSRHC’s Tuberous Sclerosis Complex clinic, where their daughter, Nicole, was being treated. That intimate brainstorming session led to a small gathering at the hospital later that year, where guests donated a “treasure” to be auctioned on behalf 
of the clinic. Treasure Street was formed and would ultimately become the hospital’s signature fundraising event, benefiting all TSRHC patients. This year hospital friends, patients and staff celebrate the event’s 20th anniversary and perhaps the greatest treasure of all — the gift of gratitude.

October 23, 1993, a date Dee can rattle off like her phone number. It was the day 11-month-old Nicole was diagnosed with Tuberous Sclerosis Complex (TSC), a rare genetic disorder that causes noncancerous (benign) tumors to form in the vital organs of the body, primarily the brain, heart, kidney, skin and lungs.

“We were at Children’s Medical Center when the doctor gave us the diagnosis,” Dee recalls. “He let us process it a little bit and then told us about the TSC clinic at Scottish Rite and said, ‘You need to get her over there.’ ”

The first Treasure Street was held in 1996 and this group has been there from the beginning. L to R: TSRHC President/CEO Robert L. Walker and his wife, Pat; Dee and Dodge Carter; TSRHC Trustee Harold Carter and his wife, Bitsy; Margaret and Syd Carter; Lark Montgomery and her husband, TSRHC President Emeritus and Foundation Executive Chairman J. C. Montgomery, Jr.

Mauricio Delgado, M.D., TSRHC director of Neurology, founded the hospital’s TSC clinic in 1990, along with former Children’s and TSRHC neurologist E. Steve Roach, M.D. Although pediatric orthopedics is the specialty, TSRHC treats certain related neurological disorders. The hospital’s TSC clinic was one of the first clinics of its kind in the country and has served as a national model for those that followed.

“The complexity of this disorder led us to organize 
a dedicated TSC clinic where we could gather relevant clinical information through a standardized approach,” explains Delgado, who became Nicole’s physician.

The clinic played a key role in creating a national database of TSC patients, which is overseen by a national organization called the Tuberous Sclerosis Alliance.

The hospital’s TSC clinic also conducted a landmark study with the University of Texas Medical School at Houston, which isolated two causative genes associated with the condition.

“The financial support from Treasure Street played a critical role in our genetic testing,” says Steven Sparagana, M.D., who joined TSRHC in 1994 and became director of the TSC clinic in 2001. “Now we know the mechanism by which the disease occurs.”

In TSC, that mechanism is a mutation, or change, in one of two genes, TSC1 or TSC2. When either of these genes carries a mutation, it is unable to inform the body how to grow correctly, which affects proper development and function in children with TSC.

“This condition is complex and it exhibits differently in every patient,” Sparagana explains. “An accurate diagnosis is key and from there, finding a cure remains our ultimate goal.”

“There’s so much that we’ve come to know about the disease, but there’s still so much that is unknown,” Dodge explains. “There’s a huge level of comfort in knowing that you’re with the experts at Scottish Rite, because it’s not just the patients the hospital cares for, it’s the families as well.”

Funds from Treasure Street continue to meet the needs of the TSC clinic, in addition to supporting the hospital as a whole. Twenty years, thousands of guests and $11 million in gross proceeds later, the event has exceeded 
all expectations.

“We never dreamed it would come this far,” Dee says. “We’re so grateful for the generosity of the community and our friends. The success of the event speaks to them, and to the hospital. It’s touched so many lives.”

The Carters explain that Treasure Street is a celebration of the hospital and those who support it, like Dee and Dodge’s parents.

“They’ve been with us from the beginning,” Dee says. Her mother, Bitsy, and father, Harold, a TSRHC trustee, are active on the Treasure Street board, as are Dodge’s parents, Margaret and Syd. Dee and Dodge are also grateful for the involvement of friends like longtime event board members Kammy and Andy Fleck.

“Part of the joy now is that we have a host committee that is comprised of our kids,” Dodge says. “So, the families involved in this event have gone full circle and now we’re establishing a foundation for the future.”

“It’s the little things we’re grateful for, too,” Dee says. “Nicole has never been afraid to go to Scottish Rite and that means so much, to bring your child to a place where they aren’t afraid to be.”

It’s that gratitude for the small things that has culminated in big things, like celebrating the 20th anniversary of Treasure Street this fall on Thursday, Oct. 15. There will be fabulous food, live music and, of course, treasures to bid on at both silent and live auctions. But as the Carters know firsthand, there are some treasures upon which you cannot put a price.

“What can you do for an institution like Scottish 
Rite that does everything it can to help your child?” Dodge asks. “You can’t repay that. But our goal from the beginning has been to tell people about the hospital and it’s a story we feel blessed to tell.”

**This article was featured as the cover story of our Rite Up magazine.

TSRHC Sports Medicine Patient Spotlight: Jake

Jake injured his knee while playing football when he was 10 years old, take a look at his story of returning to his favorite sport after anterior cruciate ligament reconstruction. The sports medicine experts at the Texas Scottish Rite Hospital for Children know how to take care of growing athletes, like Jake. Providing injury management and even arthroscopic surgery, Philip Wilson, M.D. and his partners are giving children back their childhood.


Waiting until August to prepare for fall football in Texas is a mistake for young athletes – TSRHC Sports Medicine

Dr. Shane Miller, TSRHC sports medicine pediatrician, warns parents about the serious risks of returning to Texas football poorly prepared.

football“Though heat illness prevention practices have greatly improved in Texas schools, I worry about the kids that sit on the couch all summer playing video games in the air-conditioning. They show up to pre-season training out of shape and poorly prepared for the heat,” he says.

To manage heat from the environment and from activities, the body must be in balance. Most athletes need guidance from adults to make good choices throughout the year, especially in the summer.

Tips for parents and coaches who want to reduce the risk of heat-related illnesses in young athletes in all sports:

  • Encourage healthy sleep habits
  • Keep healthy food options in the house
  • Limit consumption of caffeinated and sugary beverages
  • Encourage drinking water throughout the day
  • Encourage physical activity throughout the summer
  • Encourage acclimating to the heat BEFORE training begins
  • Notify athletic trainers of fever or changes in medical history

Screen Shot 2015-08-06 at 10.45.16 AMAdditionally, coaches can help reduce the risk of heat-related illnesses with these tips:

  • Encourage frequent and adequate rest and water breaks, every 15 – 30 minutes
  • Know the signs and symptoms of heat illness
  • Insist on proper conditioning, it takes 10-14 days to adapt to heat
  • Avoid practice from 12:00 – 4:00 pm when the Texas sun is most intense
  • Follow league guidelines for practice schedules
  • Respond to temperature and humidity warnings

To learn more about proper hydration for young athletes, see our PDF. For information about TSRHC’s Center for Excellence in Sports Medicine, please visit our website at



Crayon Club Membership Drive until August 28

Screen Shot 2015-08-04 at 1.31.58 PMHave you been thinking about joining Crayon Club? Now is the time! Crayon Club provides opportunities to create friendships, network and connect with others interested in making a positive impact in their community. Check out the following three membership levels to find the one that is right for you. These gifts help underwrite patient care, research, medical equipment and building renovations at TSRHC:

  • RED CRAYON: $40: Let your passion for TSRHC patients shine through! This level includes…
    • Reduced ticket price for each annual Crayon Club event (4 per year)
    • Crayon Club koozie
  •  BLUE CRAYON: $130: Contribute to life changing care for TSRHC patients! This level includes…
    • One ticket for each annual Crayon Club event (4 per year)
    • Crayon Club t-shirt
  •  GREEN CRAYON: $220: Be part of the new generation of TSRHC philanthropists! This level includes…
    • One ticket for each annual Crayon Club event (4 per year)
    • Recognition at Crayon Club events
    • Crayon Club t-shirt and koozie

Join Today!

* Discounted rates are available until midnight on August 22, 2015.
** Your contribution is tax deductible to the full extent of the law. Goods or services will be provided in exchange for part of your donation.