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Winter: the Dolphin with the Prosthetic Tail

wintertail copyA few of our staff members attended the Association of Children’s Orthotic-Prosthetic Clinics (ACPOC) annual conference in Clearwater Beach, FL earlier this month. ACPOC is an association of interdisciplinary professionals who are involved in providing prosthetic-orthotic care for children with limb loss or orthopedic disabilities.  We participated in the conference by presenting two clinical papers, which were very well received and encouraged valuable discussion. The hospital was even specially recognized by ACPOC for our attendance to the conference as a team!

Despite the long hours at the conference, Amanda Brown from Prosthetics and Orthotics and Jesse Kowalski from Physical Therapy managed to squeeze in some time to spend an afternoon at the Clearwater Beach Aquarium. This special aquarium is home to Winter, the famous dolphin. Winter is the only known dolphin in the world missing her tail, and was featured on the big screen in Dolphin Tales.

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Like many of our patients, Winter has scoliosis and kyphosis, which has caused her to wear a prosthetic tail. She wears her prosthetic device during physical therapy sessions to help decrease the progression of the curvature of her spine, and has to do other types of stretching and exercise too. Her prosthesis helps keep her healthy and happy so she can do what dolphins do best… play!

A World of Expertise, Locally Grown

By Manny Mendoza

When TSRHC hosted the World Hand Symposium, orthopedic physicians from
 19 countries flocked to the hospital to learn about the latest treatments for upper limb disorders. Why Scottish Rite Hospital?

It’s home to two of the world’s preeminent pediatric hand surgeons, consistently ranks as one of the top pediatric orthopedic facilities in America and is renowned for its groundbreaking research.

flowerSuch locally grown leadership from the TSRHC medical staff plants seeds that encourage ideas and innovations to bloom across the globe, cultivating a brighter future for children with orthopedic conditions in the United States and abroad.

In addition to traveling from overseas to attend medical conferences put on by the hospital, doctors come to TSRHC
 to train with its superior medical team. Last year alone, physicians came from 39 countries. They also wrangle for spots in the world-class fellowship programs at TSRHC, taking some of the hospital’s expertise back home with them. They come here because Scottish Rite Hospital’s commitment to the highest standards has put it on the world stage of pediatric orthopedic care.

And the world has taken notice. In addition to international representatives from the medical community, more than 300 current patients from nearly 60 countries travel to TSRHC to benefit from the hospital’s expert treatment. “We are a destination,” says Chief of Staff Daniel J. Sucato, M.D., M.S. “We help set the standard.”

Sucato’s predecessor, now Chief of Staff Emeritus John A. “Tony” Herring, got the international ball rolling in the 1980s when he began visiting countries such as China and Russia, teaching their doctors the Scottish Rite way and treating their patients with TSRHC’s superior know-how. Last year alone, TSRHC physicians and researchers lectured in 15 countries in addition to training medical personnel across the U.S.

The hospital’s training of domestic and foreign physicians results in better care of children with orthopedic conditions around the world, while also spreading TSRHC’s philosophy of providing superior treatment to children regardless of their family’s ability to pay.

How sought after is the hospital’s expertise? More than 160 physicians, or more than 10 percent of the pediatric orthopedic surgeons in North America, completed their advanced instruction in TSRHC fellowship programs. Internationally, Scottish Rite Hospital fellows have come from 21 countries, representing every continent but Antarctica, with many going on to assume leadership roles at medical institutions in their home countries.

The reach of TSRHC’s research team is equally broad. As a major medical research center, the hospital directs international studies such as leading the International Perthes Study Groupa team of physicians from the U.S. and eight other countries who came together to discover new approaches to Perthes disease, a hip disorder.

In addition, the hospital develops innovative treatments that lead to better outcomes for children with pediatric orthopedic disorders. For example, when the TSRH Spinal System for correcting spinal deformities was introduced, it was the most widely used treatment of its kind internationally. The hospital has also established itself as a global leader in limb lengthening and reconstruction, building on the work of Russian physician Gavril A. Ilizarov. Improving on his original frame, TSRHC orthopedists and researchers have created a series of patented limb-lengthening devices recognized around the world.

The impact of Scottish Rite Hospital’s leadership on the direction of pediatric orthopedics is evident through the high-ranking positions TSRHC physicians hold in esteemed medical associations. Chief Medical Officer
 B. Stephens Richards, M.D., recently led the Scoliosis Research Society (SRS). In addition, Richards and Herring are former presidents 
of the Pediatric Orthopaedic Society of North America (POSNA), whose archive is housed at TSRHC. Assistant Chief of Staff Lori A. Karol, M.D., is president-elect of POSNA. She will become the first woman to assume the role of president at POSNA’s annual meeting in May.

With its international influence and dedication to education and collaboration, TSRHC has blossomed from its Texas roots into one of the most respected pediatric orthopedic institutions in the world. In that thriving spirit, TSRHC is constantly growing, evolving and reaching skyward, so that children – no matter where they are – can, too.

**This article was feature as the cover story of our Rite Up Magazine – 2015, Issue 1. View an e-mag version for more stories from this issue.

TSRHC Leads the Way with Magnetic Spinal Rod System

TSRHC physicians recently performed the hospital’s first noninvasive adjustment of an implanted spinal rod system using groundbreaking magnetic technology. This system is designed to minimize the progression of specific cases of early-onset scoliosis. This revolutionary device is called MAGEC (MAGnetic Expansion Control) System®, distributed by Ellipse Technologies, Inc.

Daniel J. Sucato, M.D., M.S., TSRHC chief of staff, with TSRHC patient Viviana, age 7, of Austin, after her adjustment.

Daniel J. Sucato, M.D., M.S., TSRHC chief of staff, with TSRHC patient Viviana, age 7, of Austin, after her adjustment.

The FDA cleared the system for commercial use earlier this year. It
 is composed of an implantable rod and an External Remote Controller (ERC). After the MAGEC rod has been implanted, a physician simply places a “MAGEC wand,” or locator, over the patient’s spine. The wand locates the magnet on the implanted rod and allows the physician to make a noninvasive adjustment. An X-ray or ultrasound of the spine is then used to confirm the procedure’s success.

Thus, adjustments that once required a patient to undergo anesthesia, surgery and recovery are now performed in the clinic in a matter of minutes.

The frequency of such sessions 
is customized to meet the needs of each patient until the desired result is achieved. TSRHC is excited to be at the forefront of institutions in the U.S. providing patients with this revolutionary, nonsurgical adjustment technology.

 

**This article was featured in the 2014 Rite Up Volume 3 Magazine. Read more from the magazine online

West Texas A&M Students Help Design New Prosthetic

Young, energetic students at West Texas A&M are making great steps forward in both their chosen field of engineering and in helping their fellow Texans.  A group of four students spent a full semester working on a prosthetic hand designed for patients with Symbrachydactyly (a common hand and foot disorder).

The Idea

TSRHC collaborated with West Texas A&M engineering professor, Dr. Emily Hunt, with the idea of designing a new prosthetic hand.  Guided by Dr. Dwight Putnam of Texas Scottish Rite Hospital for Children, the students took up the project eagerly and were aided through this special project by Dr. Hunt and her 10-year-old daughter Aly who has Symbrachydactyly.

The Design

TSRHC Pediatric Orthopedics

The base design came from a prosthetist from South Africa who posted the design online for any who wished to download for free.  From there, the students worked the design carefully, using common tools including bungee cords, fishing line, and a 3-D printer.  Aly tested drafts of the design and gave the students feedback, helping them understand the needs and preferences of the patients who will actually use the prosthetic.

The design functions through simple muscle movement.  When Aly bends her wrist, the fingers close, when she straightens it, the fingers open.  Aly said it is easy to use and finds it very helpful.  What is even more impressive is that the hand can be produced for a mere $15!

The Human Element

The West Texas A&M students who worked on the project said it was a truly unique and inspiring project.  Engineering students rarely get to work on something that has such a significant impact on actual people with specific needs.

Working with the hospital, Dr. Hunt, and Aly, added a human element that increased the value and importance of their work.  Receiving instant patient feedback and suggestions helped them identify problems, improve the design, and ultimately become more successful engineers.  It was an experience they aren’t likely to forget and their work is sure to bless the lives of thousands of patients to come.

Photo Credit: Sean Steffen – Amarillo Globe News

TSRHC Releases Groundbreaking Bone Deformity Correction Device TL-HEX

Do you remember the stories of how computers used to fill up an entire room?  Then, by the mid-1990s, almost every private citizen and business owned a personal computer.  Towards the end of the 1990s, everyone had an internet connection.  By the mid-2000s, every college student owned a laptop.  Now, in 2013, tablet PCs, which possess exponentially more power than computers of old and are just a fraction of the size, are commonplace across the globe.

This story illustrates a basic point:  advances in technology seem slow, but over time, their changes accumulate, creating a big difference in the world.

Similar changes happen in the realm of medical technology.  At Texas Scottish Rite Hospital for Children, our medical doctors and biomechanics professionals have been working vigorously to develop a more effective method for correcting bone deformities.  And, at long last, we’ve made another breakthrough, making bone deformities, malformations, fractures and lengthening easier to treat than ever before.

The Current Leading Bone Deformity Correction Device:  TRUE/LOK

In 1993, TSRHC developed the TRUE/LOK® External Fixation System, a four-strut system used to correct bone deformities and lengthen limbs.  For the past 20 years, it’s been the simplest, most stable, and highly versatile system for correcting a number of bone fractures, nonunions, malunions, and other deformities.

By offering a system of pre-assembled hinges, angular distractors, and other easy-to-manipulate components, the TRUE-LOK® External Fixation System has set the standard for correcting bone deformities in hospitals around the world.

The TL-HEX Brings More Stability and Flexibility

TL-HEX However, as with many things, a good thing often leads to an even better thing. Although TRUE/LOK continues to help kids around the world, a new beginning provided by the TL-HEX offers a much more flexible and stable solution.

David Ross, director of TSRHC Bioengineering and Biomechanics, Mikhail Samchukov, M.D.* and co-director of the TSRHC Center for Excellence in Limb Lengthening and Reconstruction, and Alex Cherkashin, M.D.**, a division director at the center, collaborated to create a device even more effective than the TRUE/LOK.

TL-HEX  fittingAlthough the TL-HEX visually appears quite similar to the TRUE/LOK, it uses six struts, a lightweight aluminum frame, and sophisticated software technology to correct bone deformities.

“Using six struts allows us the capability to lengthen, to rotate and to compress the bone – all at once,” said Samchukov.

Through a system of circular and semi-circular supports, the TL-HEX affixes a patient’s bones by wires and half pins, which are connected by the six struts.  This allows both rapid and gradual ring position, enabling the practicing physician to reposition bone segments with incredible precision and control.

The TL-HEX also maintains full compatibility with the TRUE/LOK system.

A Large Differentiator Between TRUE/LOK and TL-HEX:  Software

One of the greatest differences between the TRUE/LOK and TL-HEX is the software support that comes along with the TL-HEX.  This software shows physicians how to make the following types of precision adjustments:

  • Distraction
  • Angulation
  • Translation
  • Rotation

The device has already been launched internationally, with South Africa playing host to the first surgery taking advantage of the TL-HEX.  Throughout the next year, the device will be launched in several additional international markets.

*Medical degree from Khabarovsk State Medical School, Russia.
**Medical degree from Novosibirsk State Medical School, Russia.