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Texas Scottish Rite Hospital for Children: Patient Care, Education, & Research

Texas Scottish Rite Hospital for Children opened its doors in 1921 and over the last 95 years it has become one of the top pediatric orthopedic hospitals in the country. Ortho Group Photo 2016_FinalAt the core of our mission are three main pillars: patient care, research, and education. The outstanding patient care provided at the hospital is shown each and everyday through the interactions our medical staff has with all of our patients and families. The research conducted is designed to treat the entire child and his/her specific needs. The hospital is the training ground for the next generation of world-class pediatric orthopedic physicians through the fellowship program. It is the superior patient care, the groundbreaking research, and education of physicians that makes Scottish Rite Hospital such a special place.

Scottish Rite Hospital is a unique institution because of its many resources when it comes to innovation and research. The success of the hospital and its top of the line patient care is closely tied to the collaborative relationship with UT Southwestern Medical Center (UTSW). Monday Night Conference_26All of our medical staff hold faculty appointments in various departments at UTSW, including Orthopedic Surgery and Pediatrics. It is a strong, working relationship in which Scottish Rite Hospital has become one of the top research institutions in pediatric orthopedics. The research at Scottish Rite Hospital is regulated by the Institutional Review Board (IRB) at UTSW, which serves as the governing body for over 100 of our clinical research studies. Additionally, Scottish Rite Hospital welcomes several UTSW orthopedic residents to complete pediatric rotations throughout the year. These residents work closely with our medical staff and research department to gain experience both hands on in clinic and surgery, as well as with various research studies.

Scottish Rite Hospital is internationally known as a premier research and teaching hospital. Since research is at the forefront of providing the best patient care, it is necessary to have an environment where learning is ongoing and teaching is an everyday practice. The hospital provides several areas for medical staff, fellows, residents and all other staff to continue their education through weekly/monthly conferences, symposiums, visiting professorships and much more. An extraordinary aspect of Scottish Rite Hospital is the Dorothy & Bryant Edwards Fellowship in Pediatric Orthopedics and Scoliosis.

 

This program provides the fellows an opportunity to work with some of the most experienced pediatric orthopedic staff in the country. The yearlong fellowship includes becoming a member of the patient care team, high-level surgical experience, and the opportunity to work closely with the research team on a topic of their choice. Even through the fellowship, research is at the core of the curriculum. The fellows are required to complete at least one scientific manuscript at Scottish Rite Hospital and will have the opportunity to present their work at the annual Brandon Carrell Visiting Professorship. This conference, hosted by the hospital, is an annual course designed for pediatric orthopedic surgeons and others with an interest in pediatric orthopedic practices to keep up-to-date on the latest in groundbreaking research. The hospital welcomes a visiting professor each year, along with other medical professionals, who will present on their current research projects. It is another opportunity for our medical staff to discuss and debate various techniques, which facilitates ongoing education for all.

Fellowship Programs:

It is through our strong relationship with UT Southwestern Medical Center, accompanied by the continuous learning environment, which has established Scottish Rite Hospital as a leading research institution for pediatric orthopedics. Research continues to be the engine that drives important clinical decision making to improve the care by finding new and better techniques to treat our patients.

Get to Know Our SRH Staff – Psychology Department

There are many reasons why Scottish Rite Hospital is a unique and special place, and giving our patients access to a renowned Psychology department is one of the ways we set ourselves apart.

Rooted in our mission of treating the whole child, our Psychology department helps kids with everything from mentally preparing for surgery to coping with a sports injury to overcoming the long recovery process associated with many of the procedures done at our hospital.

Psychology with Ashley Imoh_01According to department director Sandy Roland, Ph.D., “What giving children back their childhood means to me is that even when we are treating a child for a specific orthopedic condition, we never lose sight of the whole child during that process.” In 2015, they saw an average of 190 patients a month, with a range of conditions from all services at Scottish Rite Hospital: neurology, orthopedics, rheumatology and hand, among others. They also work with patients on non-orthopedic matters including individual and family therapy as well as behavior and pain management.

Above and beyond all the positive work they are doing with our patients, our Psychology department is making waves in the medical world as well. They conduct research, publish papers and present at prestigious medical conferences about the correlation between psychological risk factors and effects on postoperative recovery. They have had papers published in non-psychology journals, demonstrating the importance of an interdisciplinary approach in pediatric orthopedic care.

As the only pediatric orthopedic institution with a dedicated psychology department, who understand the medical conditions and how it affects all aspects of a patient, we are blazing a trail of holistic treatment for the medical community to follow.

Join our Team

Do you or someone you know have an interest in pursuing a career in psychology? We’re currently hiring a psychologist. Qualified candidates must hold a Doctorate in Psychology with licensure or licensure eligibility issued by the Texas State Board of Examiners of Psychologists (TSBEP). For more information on the position and to apply, read more on our website.

My Child Has a Buckle Fracture, Now What? – Fracture Clinic Tips

A buckle fracture, also known as a torus fracture, is a very common injury for children. Because pediatric bones are softer and more flexible than adult bones, one side of the bone may buckle (or bend) upon itself without disrupting the other side of the bone. Buckle FractureThese fractures are most commonly seen in the wrist and are often caused by a “FOOSH” (Fall On Outstretched Hand) injury. Buckle fractures can also occur in other bones throughout the body.

These are common injuries that tend to heal quickly with low risk for complications. The typical treatment for a buckle fracture is aimed at keeping the patient comfortable while allowing the bone to heal. Sometimes this may include a cast or splint. Deciding which treatment is best for your child depends on the fracture pattern, the child’s comfort, and the parent’s comfort level with the treatment plan.

Most buckle fractures heal uneventfully with no long term complications. Our fracture clinic staff are experts at managing fractures and other injuries in growing bones. We are here when you need us. Call for an appointment at 469-515-7200 or to learn more about our Fracture Clinic on our North Campus, visit scottishritehospital.org/fracture.

Returning to Play after an Injury – Special Considerations for Young Athletes – TSRHC Sports Medicine

Whether your child is the star quarterback ready for college recruiters or just starting a youth sports program, we know safety is important to you. As pediatric sports medicine specialists, we are also dedicated to preventing injuries. Research has shown that overuse injuries, problems from repetitive motions with running, jumping and throwing, are preventable. An evolution of equipment and rules has helped to reduce other injuries in young athletes. Jamie Wightman, Scottish Rite Hospital athletic trainer, reminds us that “young athletes are still growing, so it is important to remember that these injuries often happen at sensitive areas of the bone called growth plates.”

Demiya Warren age 16_22Some injuries are going to happen, and once they do, it’s important to respond appropriately and to return to sports only when the injured area is ready. This is important for a couple of reasons. First, there is no need to play with pain or make pain and symptoms last longer because the area hasn’t healed. Additionally, pain can cause an athlete to compensate or begin to use their body differently to protect the injury. This can lead to new injuries.

We know what it takes to get back on the field after an injury. Depending on the injury, recommendations may include rest and rehabilitation, or in some cases surgery may be considered. We asked our sports medicine experts to tell us a few things they consider when helping families discuss returning a young athlete to sports. Here is what they told us:

  • Level of competition – What was the athlete’s level of competition before the injury, and is he or she planning to return to that level?
  • Sport, position and season timing – What is the sport and position(s) played? How much of the season is left?
  • Years of Growing Left – How long do we think the child will continue to grow and are the treatment options different based on their growth?
  • History of previous similar injuries – Has the athlete had similar injuries before, and if so, how many times?
  • Functional Strength and Stability – How well does the athlete perform standardized tests of stability and strength and will those skills translate to his or her chosen sport?

These are just a few of the questions to consider, and there are no right or wrong answers. That’s why a multi-disciplinary team of pediatricians, pediatric orthopedic surgeons, physical therapists, athletic trainers, psychologists and others can provide the best advice. As a research and teaching hospital, we use evidence to help families make decisions, not our experience alone.

For information about injury prevention and pediatric sports medicine, please visit our website at scottishritehospital.org/sports.

Heat Illness in Young Athletes – TSRHC Sports Medicine

Recognizing and responding to the signs and symptoms of heat illness is critically important. Though body temperature may not be elevated, heat illness may still be present.

Signs and Symptoms of Heat Illness

  • Weakness
  • Vomiting
  • Excessive Thirst
  • Headache
  • Fatigue
  • Sweating
  • Nausea
  • Light-headedness

Keeping Cool When Exercising in the Heat

  • Take rest and water breaks, every 15 – 20 minutes
  • Avoid the hottest hours from 10 a.m. – 5 p.m.
  • Drink a sports drink with electrolytes and 6-8% carbohydrates when training lasts over 60 minutes
  • Avoid training in direct sunlight
  • Take breaks in the shade
  • Encourage removal of equipment during breaks, e.g. helmet
  • Wear loose-fitting, light-colored and moisture-wicking clothing

Be prepared

  • Prepare ice and water before training sessions
  • Limit consumption of caffeinated and sugary beverages
  • Gradually increase physical activity in the heat
  • Continue conditioning in the off-season
  • Don’t train in the heat while you are sick or have a fever

Ways to respond quickly to signs and symptoms of heat illness

  • Full body immersion in an ice bath
  • Iced down towels applied all over the body

Read this PDF about proper hydration in young athletes. Learn more about our pediatric sports medicine at scottishritehospital.org/sports.

2016 LLRS Annual Meeting: Dr. Karl E. Rathjen Appointed President of the Organization

The Limb Lengthening and Reconstruction Society (LLRS), an association for the study and application of the methods of Ilizarov-North America, is holding its 25th Annual Scientific Meeting in Charleston, South Carolina on July 22 and 23. The LLRS is an organization dedicated to researching new treatment for limb reconstruction, limb lengthening, extremity deformity correction, and complex fracture treatment. Texas Scottish Rite Hospital for Children is represented at the meeting by Karl E. Rathjen, M.D., David A. Podeszwa, M.D., John Birch, M.D., Alexander Cherkashin, M.D., Mikhail Samchukov, M.D., and current fellow, Connor Green.

Dr-Karl-RathjenAssistant Chief of Staff, Dr. Karl E. Rathjen, has served as the Vice President of LLRS for the past calendar year and was recently appointed President of the organization for the year 2016-2017. At the 2016 annual meeting, Rathjen will be co-leading the two-day meeting, while several of the hospital’s doctors and fellows will be presenting their work.

Drs. David Podeszwa, Alexander Cherkashin, and fellow, Connor Green, have the opportunity to discuss several topics to the LLRS group, which encompass some of the cutting edge research happening within the hospital’s Center for Excellence in Limb Lengthening and Reconstruction (CELLR). CELLR focuses on improving the lives of patients with different leg length discrepancies and limb deformities. Co-directed by Dr. David A. Podeszwa and Dr. Mikhail Samchukov, the center has more than 20 United States and International patents and continues to be recognized as one of the top centers in this field. The Limb Lengthening and Reconstruction Society Annual Scientific Meeting is another opportunity for our doctors and researchers to showcase the work of Scottish Rite Hospital to other institutions from across the country.

Russian Medical Leaders to Visit Scottish Rite Hospital, Advance Partnership

Dr. Alexander Gubin, director of the Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics, and his wife, Dr. Elizabeth Gubin, a neurologist, will visit Texas Scottish Rite Hospital for Children from July 24-27, part of a growing relationship between the center and Scottish Rite Hospital.

The hospital co-hosted the center’s International Scientific and Practical Conference in June, the first time that the center has collaborated with an outside institution to organize the annual meeting. It was attended by 500 medical professionals from 31 countries and marked the 45th anniversary of the center, the 65th anniversary of the development of the Ilizarov technique and the 95th birthday of the late Professor Ilizarov.

IMG_1120

L to R: Drs. Birch, Gubin and Podeszwa in Kurgan

Gubin’s vision is to open up the center to the world, starting with this ongoing exchange with Scottish Rite Hospital. Since the 1990s, the hospital has developed a number of patented modifications to the original Ilizarov technique resulting in a series of devices known as the TRUE/LOKTM External Fixation System. Gubin is interested in integrating these advances into the treatment of limb differences at the center, located in Kurgan, Russia.

Elizabeth Gubin, who practices at Kurgan Children’s Hospital, will be studying Scottish Rite Hospital’s treatment of patients with cerebral palsy. She is setting up a cerebral palsy center in Kurgan and will meet with hospital neurologists and observe clinical visits and procedures.

Alexander Gubin visited Scottish Rite Hospital and other Western institutions that employ the Ilizarov technique before deciding to collaborate with the Dallas hospital. Hospital researchers Mikhail Samchukov, Alex Cherkashin and Marina Makarov are former leaders of the Ilizarov center and worked directly with Ilizarov himself. Though the relationship goes back many years, a formal exchange of physicians was established in 2014. Two Russian orthopedic surgeons from the center have already visited Scottish Rite Hospital. Dr. David Podeszwa, the newly appointed co-director of the hospital’s Center for Excellence in Limb Lengthening and Reconstruction, went to Russia in 2015.

The collaboration also includes two limb lengthening/reconstruction studies, with plans to expand cooperative research. The center will continue to send its physicians to Scottish Rite Hospital for training, and hospital orthopedists, researchers and fellows will have the opportunity to visit the center in Russia.

DSC00096Drs. Samchukov, Cherkashin, Podeszwa, Makarov and John Birch lectured and moderated panels at the Russian conference, and Samchukov, Birch and Cherkashin (pictured left) were awarded honorary professorships for their contributions to the Ilizarov technique, the only three North Americans to receive the prestigious distinction at the meeting.

While in Kurgan, Cherkashin and Samchukov also met with an international group of surgeons at the annual TRUE/LOKTM Hex Summit to get their feedback on the Hex device developed at Scottish Rite Hospital. Dr. Podeszwa participated in a press conference on state television.

On the morning of Tuesday, July 26, Dr. Gubin will talk about the Ilizarov center in the 21st century in the Scottish Rite Hospital auditorium. Also on the program are presentations by Dr. Birch on the evolution of the Ilizarov technique at the hospital, and Dr. Podeszwa on the development of collaborations between the Ilizarov center and Scottish Rite Hospital.

Scottish Rite Hospital: The Leader in Treating Hand Disorders

From a child’s hands, imagination becomes creation. Through their hands, children explore the world around them. For thousands of children with hand and upper limb disorders, Texas Scottish Rite Hospital for Children has been a source of hope and healing. Learn how the Charles E. Seay Jr. Hand Center positions Scottish Rite Hospital as a leader in treating pediatric hand disorders.

Focus on Clinical Patient Treatment and Research

The Hand Center delivers a setting for both clinical patient treatment and clinical research focused on the treatment and care for pediatric patients with hand and upper limb disorders, says Dr. Scott Oishi, the Center’s director.

“Our clinical practice [treats] a variety of children who are either born with congenital hand differences or upper extremity differences, or patients who have had trauma or something happen to them after they’re born,” he says. “There are a lot of patients who come through here and get no surgery at all because all they really need is a lot of encouragement and ability to grow and expand their horizons.”

From treating children with congenital hand abnormalities, such as webbed fingers, reconstructing children’s hands with extra digits, or changing the position of fingers on hands, the Hand Center strives to give children back their childhoods.

Care for Patients Across the Age Continuum

Dr. Oishi and Staff Hand Surgeon Dr. Christopher M. Stutz have the privilege of seeing many of their pediatric patients from the time they’re a few days old until the time they become 18 years old. “We’re able to keep a database of our patients as far as what type of diagnosis they have, what type of surgeries they underwent, and what their outcomes were, based on very good outcome measures,” Dr. Oishi says.

“I think one of the benefits of being a patient here [at Scottish Rite Hospital] is that in our clinic, if we feel you need to have therapy, we have a therapist who is literally steps away from us,” Dr. Oishi adds.

Building Confidence Through Hand Camp

Scottish Rite Hospital patient Mason was born unable to move his left hand. Mason’s father, Randy, says initially no one was able to name the source of the problem. “In the first seven days of his life, we ended up visiting six doctors, a lot of specialists, and we got referred to [Scottish Rite Hospital],” he says. “As soon as we walked in, they were able to identify the issue.”

Dr. Oishi notes that Mason underwent a free functional gracilis muscle transfer, transferring muscle from his leg to his arm.

“He has roughly 40 to 45 percent usage of his left hand already at the age of 7. We could tell that he’s growing and getting more use all the time,” Randy says. “[Scottish Rite Hospital], with the usage of Hand Camp, has given him the confidence to be able to talk about his arm. He’s not embarrassed by his arm; he doesn’t hide his arm from his friends.”

Amy Lake, therapist and co-director of the Scottish Rite Hospital Hand Camp, says the program started in 1995 to bring families together. “A child with a hand difference can go to school, be involved in activities, and never come in contact with another kid with a hand difference,” she says.

Andrea Brown, Hand Camp co-director, says the Hand Camp instills invaluable confidence in the children who attend. Moreover, parents also benefit from interacting with one another, as they receive valuable information to help their children as well.

Trained Fellows Who Deliver Hand Treatment Excellence

Dr. Oishi emphasizes that one of the most important aspects of the Hand Center is the training this team devotes to their clinicians. “We train fellows and trainees that then go out and practice pediatric hand surgery,” he says. “Our Center’s message is really one that Peter Carter, one of our retired hand surgeons here, taught us all — the to-for rule.”

“Either do something to them or you can do something for them,” explains Scottish Rite Hospital Staff Hand Surgeon Dr. Marybeth Ezaki. “We practice that rule every single day.”

Support Those Who Support TSRHC Patients

As a world leader in treating pediatric orthopedic conditions, Scottish Rite Hospital provides the highest level of care for children from birth to age 18, regardless of a family’s ability to pay. To learn more about Scottish Rite Hospital, its mission, and ways you can support continuing research for treatment of pediatric hand disorders, call 214-559-5000 or visit scottishritehospital.org.

Little Fingers, Big Problems: Tips from our Fracture Clinic

Did you know that some of the more common injuries we see in young children occur inside the home from normal everyday objects like doors, cabinets and drawers? Young children don’t recognize the dangers associated with these and love to play with them. Since children have naturally slow reactions, fingers or toes often get caught when they slam closed.

FractureWe call these crush injuries, and they can range from minor to severe. Gerad Montgomery, Lead Clinical Provider for our Fracture Clinic says, “Many people don’t realize that crush injuries of the fingers and toes can result in cuts in the skin, nail bed injuries, broken bones, and in severe cases, partial amputation.”

Prompt evaluation by a pediatric specialist is important if any of the following signs are present:

  • Swelling or deformity
  • Skin that is split open around the nail
  • Bleeding from around or under the nail
  • Persistent pain or inability to move
  • Concern for a serious injury or the feeling that your young child just needs to be seen

Accidents happen and we can’t protect our young and curious children from everything, but we have some suggestions to help avoid injuries:

  • Teach young children early that doors and cabinets are not toys.
  • Child-proof cabinet doors and drawers with latches.
  • Be aware of doors and drawers in your child’s environment.

Bumps and bruises are a normal part of kids being kids! However, if your child has a crush injury or breaks a bone, you may call our fracture clinic directly at 469-515-7200. To learn more about our Fracture Clinic, please visit scottishritehospital.org/fracture.

23rd Annual International Meeting on Advanced Spine Techniques (IMAST)

July 13 – 16, 2016
Washington, D.C., USA

The International Meeting on Advanced Spine Techniques (IMAST), an annual conference sponsored by the Scoliosis Research Society, includes spine surgeons, allied health professionals and researchers from across the globe to discuss new and innovative spine techniques. Texas Scottish Rite Hospital for Children is being represented at IMAST 2016 by orthopedists Dr. Dan Sucato and Dr. Steve Richards, researcher Dr. Hong Zhang, and research coordinator Dong Tran. Among hundreds of submissions from institutions across the country, the work of our doctors and researchers has been selected for two podium presentations.

Sucato 2012 - 2x3“IMAST is a slightly different meeting than some of the other spine meetings we participate in because innovative and newer techniques are the focus of the meeting with ‘outside the box’ presentations and discussions”, says Sucato. Scottish Rite Hospital continues to be seen on the national stage. The opportunity to showcase our work is tremendously fulfilling, however, knowing that it can directly affect the care of a child makes it that much more rewarding.

The first presentation was authored by Eray Kilinc M.D., Dong-Phuong Tran, M.S., and Charles Johnston, M.D., analyzes 120 AIS (Adolescent Idiopathic Scoliosis) patients with specific types of curve patterns of the spine. The objective of the study is to understand whether there is a significant difference between using more vs. using less implants to correct the curve. By using less implants, the research has shown that although the results show that fewer screws achieve slightly less overall curve correction, overall satisfaction scores for both patients with more screws and less screws were similar.

Charles Johnston, M.D., Kelly Jeans, M.S., Dong-Phuong Tran, M.S., and Anna McClung, R.N.,B.S.N., authored the second selected presentation. This study evaluated EOS (Early Onset Scoliosis) patients who have undergone growing rod treatment. The objective was to assess whether children with EOS were able to keep up with their peers based on a graded exercise test. The study builds on earlier research, which has shown that children who have undergone extensive treatment are thought to have limited capacity regarding physical activity. The study included 12 patients who were tested while walking at a self-selected speed over-ground and then during a graded exercise test. In conclusion, our researchers discovered that patients with EOS are not only able to keep up with their peers while walking around their communities, but they also have the capacity to exercise.

For more information on our research initiatives, please visit scottishritehospital.org/research.