Wednesday, August 31, 2016

Orthopedic technology improves care at Children’s

By: Shawn Gilbert MD

Dr. Shawn “Skip” Gilbert, is the new chief of the division of pediatric orthopedics at Children’s of Alabama. He graduated from medical school at the University of North Carolina, and completed a fellowship in pediatric orthopedic surgery at Children’s Orthopaedics of Atlanta in 2003 before coming to Children’s of Alabama and UAB.

Orthopedic doctors at Children’s of Alabama have new tools that are helping us perform classic medical procedures with more precision, fewer complications and increased comfort for our patients.

Among these many technological innovations, we’ve harnessed the power of magnets to lengthen deformed limbs and straighten growing spines. Our ability to produce medical images is getting better and safer, while our capacity to store and analyze information is improving.

Limb lengthening is a fundamental operation in pediatric orthopedics. It evens the lengths of two limbs. This involves an operation to cut the bone and install mechanical devices on either side of the intentional fracture. These devices are then slowly adjusted over weeks and months to kind of trick the bone into healing as it lengthens. Supporting tissue also grows along with it.

It’s a great operation, and it’s been used for decades. But in the past, it required an external metal scaffold, or fixator, held in place with pins that protruded through the skin and into the bone. Obviously, it was uncomfortable, severely limited the patient’s mobility and could lead to complications, such as infections.

Now, for many patients, we are using a magnetically controlled lengthening rod within a rod that is implanted within the bone. As the bone grows, the device is adjusted with a powerful magnet. It’s a welcome improvement that eliminates many possible complications and is far more comfortable for patients.

The same technology is now being used with rods that we use to strengthen and straighten deformed spines as they grow. In the past, we installed these rods with an operation, and then would have to perform minor surgeries twice a year to lengthen the rods. This added up to several surgeries over several years. Magnetically controlled lengthening rods have eliminated the need for those smaller surgeries in many patients. Again, this is reducing complications and increasing patient comfort.

Also under the heading of technological innovations, we’re preparing to go online with a new, state-of-the-art EOS X-ray imaging system. The system takes two pictures at once from different angles using much lower doses of X-rays than conventional X-rays. The images can then be combined to make a 3-D image at a fraction of the radiation dose of traditional CT scanning.

The system is capable of scanning a child while standing upright, which allows us to examine a child’s weight-bearing posture and interaction between the joints and musculoskeletal system. This will help us better evaluate children, primarily with spine, hip and leg disorders.

In a slightly less exciting development, we expect to switch to a new electronic medical record system next year. The current system allows us to record notes for patient care, but the new system will provide better consistency, communication and the potential for researching treatments and outcomes.

Orthopedics at Children’s of Alabama has four full-time orthopedic surgeons who exclusively devote their practice to children and we are affiliated with two sports medicine physicians. We have two advanced practitioner nurses and one physician assistant. We operate out of two locations—our Children’s South off I-459, and of course, the Russell campus downtown.

We see just about every kind of musculoskeletal complaint in children. We tend to perform many surgeries to correct scoliosis in children and hip dysplasia in babies. As I mentioned earlier, I work with limb deformities and we also have a clinic for amputees. We respond to trauma injuries, both big and small.

We strive to be accessible and ensure that patients get to us a timely fashion. Being part of the Children’s community is special for us. It allows us to deliver high quality care and work in a great team atmosphere.

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