| Therapy in Palm Beach, limb-lengthening surgery helping children gain normalcy |
| DR. PALEY'S MEDIA SECTION |
| Palm Beach Daily News |
By DAVID ROGERS, Daily News Staff Writer
Saturday, August 08, 2009
When 10-year-old Graham Rider of Essex, Conn., prepares for a dip in the
pool, he has a few more steps to take than most.
On one of his recent regular visits to the Rehabilitation Center for Children &
Adults in Palm Beach, his mom, Paulette, slips a pair of basketball-style
shorts up to his hips.
The shorts are slit up the side to allow them to fit over two sets of external
fixators on his legs. Graham and his mom remove gauze wrapped around
pins connected to his bones. He winces as he removes one piece of gauze.
"Ouch."
Thin tracks of exposed muscle tissue illustrate the movement of the metal
frames as they slowly stretch his upper and lower leg bones across 10 weeks.
In about a week, the device, tightened by Graham four times a day with an
Allen wrench, will have added a total of 4 inches to his legs.
Saturday, August 08, 2009
When 10-year-old Graham Rider of Essex, Conn., prepares for a dip in the
pool, he has a few more steps to take than most.
On one of his recent regular visits to the Rehabilitation Center for Children &
Adults in Palm Beach, his mom, Paulette, slips a pair of basketball-style
shorts up to his hips.
The shorts are slit up the side to allow them to fit over two sets of external
fixators on his legs. Graham and his mom remove gauze wrapped around
pins connected to his bones. He winces as he removes one piece of gauze.
"Ouch."
Thin tracks of exposed muscle tissue illustrate the movement of the metal
frames as they slowly stretch his upper and lower leg bones across 10 weeks.
In about a week, the device, tightened by Graham four times a day with an
Allen wrench, will have added a total of 4 inches to his legs.
| Jeffrey Langlois |
Ellen O'Bannon, director of physical therapy at the
Rehabilitation Center for Children & Adults, works
on 13-year-old Nate Allen's range of motion. 'I just
want to be able to jump around like everybody, be
able to do stuff (and) walk without having to walk
on my toe or wearing a lift,' Nate said.
Rehabilitation Center for Children & Adults, works
on 13-year-old Nate Allen's range of motion. 'I just
want to be able to jump around like everybody, be
able to do stuff (and) walk without having to walk
on my toe or wearing a lift,' Nate said.
Dr. Dror Paley, a pediatric orthopedic surgeon at St. Mary's Medical Center, performed limb-lengthening surgery on
Graham on June 3. It involved implanting the external fixators and then fracturing the leg bones. As the soft tissue on each
side of the fracture attempts to close the gap and calcify, the fixators extend the distance between the bones, a little at a
time, to lengthen them.
While he has moments of pain — and can't walk outside the pool for now — Graham says the procedure was worth it.
His growth has been stunted by achondroplasia dwarfism. Without the surgery, he would likely reach only 4 feet in height.
This, another leg surgery he plans to have in three years will help him reach 5 feet. He wants the added height "so I could
be able to ride roller coasters that I really like and be able to play basketball with my friends and not have the basketball
hoop as low as it can be, and so that I can run faster than I normally do."
It also will allow him to reach a sink without standing on his toes, he says. And will keep insensitive children from jokingly
using his head as an armrest. That's happened more than once, he says. While some little people disagree with limb-
lengthening surgery, asserting that they should be accepted as they are, the procedures, including one planned in coming
years to lengthen Graham's arms, will give him a better life, said Paulette Rider. Her husband, also named Graham, takes the
boy to rehab sometimes.
Little people can have difficulty reaching light switches, getting items out of upper cabinets and driving without extension
equipment.
"I just think for us in our world, being able to function as normally as possible in an average home built for an average
person was our goal," Paulette Rider said. "Everyone has a different opinion. For us, the facts are he will have much more
independence and much more opportunity in life just being able to function a little easier."
A different reason for surgery
While Rider is adding height, Nate Allen, 13, of North Canton, Ohio, wants his leg growth stopped.
Nate was diagnosed with bone cancer at age 9. A complication from reconstructive surgery at the Mayo Clinic in Minnesota
required the removal of 2 inches from his right leg. Last summer, while still practicing in Baltimore, Paley corrected the
alignment of a bone in Nate's leg and drilled out his growth plates. He is now 5 feet, 10 inches, and the leg discrepancy has
increased to 3 inches.
A recent surgery by Paley at St. Mary's on Nate's right leg — which implanted an external fixator — and another Nate will
have at 16 or 17, will allow the teenager's legs to be equal length. Nate said he wants to get back to a "normal" life. His dad,
Jeff, a clinical director at a crisis intervention center, competes in triathlons, and Nate used to participate in them as well.
"I just want to be able to jump around like everybody, be able to do stuff (and) walk without having to walk on my toe or
wearing a lift," Nate said.
Nate and his mom, Laura, a second-grade teacher in Canton, are staying at Quantum House, on the St. Mary's campus,
while he completes pool therapy at the Rehabilitation Center.
Like dozens of other families, the Allens followed Paley to West Palm Beach for surgery and are spending months away
from home during the limb-lengthening and/or limb-restoration process. Traveling to the Mayo Clinic for cancer surgery
and chemotherapy separated the family for weeks on end, and so is this process.
Laura Allen has only seen her husband and her other son, 10-year-old Matt, twice in the past eight weeks. "It's tough. There
are tears on the phone and that's hard to deal with. But this is for Nathaniel. We all know this. This is a family sacrifice."
"What he went through before, going through cancer was 10 times, 1,000 times worse than this," she said. "This isn't fun.
He doesn't like looking at this (fixator). He doesn't like knowing this goes directly in, but he knows that what he persevered
through before was life and death. This is to make his life more bearable ... He's had this period of being limited and now,
he's going to have his life back."
Direct link to this story
Graham on June 3. It involved implanting the external fixators and then fracturing the leg bones. As the soft tissue on each
side of the fracture attempts to close the gap and calcify, the fixators extend the distance between the bones, a little at a
time, to lengthen them.
While he has moments of pain — and can't walk outside the pool for now — Graham says the procedure was worth it.
His growth has been stunted by achondroplasia dwarfism. Without the surgery, he would likely reach only 4 feet in height.
This, another leg surgery he plans to have in three years will help him reach 5 feet. He wants the added height "so I could
be able to ride roller coasters that I really like and be able to play basketball with my friends and not have the basketball
hoop as low as it can be, and so that I can run faster than I normally do."
It also will allow him to reach a sink without standing on his toes, he says. And will keep insensitive children from jokingly
using his head as an armrest. That's happened more than once, he says. While some little people disagree with limb-
lengthening surgery, asserting that they should be accepted as they are, the procedures, including one planned in coming
years to lengthen Graham's arms, will give him a better life, said Paulette Rider. Her husband, also named Graham, takes the
boy to rehab sometimes.
Little people can have difficulty reaching light switches, getting items out of upper cabinets and driving without extension
equipment.
"I just think for us in our world, being able to function as normally as possible in an average home built for an average
person was our goal," Paulette Rider said. "Everyone has a different opinion. For us, the facts are he will have much more
independence and much more opportunity in life just being able to function a little easier."
A different reason for surgery
While Rider is adding height, Nate Allen, 13, of North Canton, Ohio, wants his leg growth stopped.
Nate was diagnosed with bone cancer at age 9. A complication from reconstructive surgery at the Mayo Clinic in Minnesota
required the removal of 2 inches from his right leg. Last summer, while still practicing in Baltimore, Paley corrected the
alignment of a bone in Nate's leg and drilled out his growth plates. He is now 5 feet, 10 inches, and the leg discrepancy has
increased to 3 inches.
A recent surgery by Paley at St. Mary's on Nate's right leg — which implanted an external fixator — and another Nate will
have at 16 or 17, will allow the teenager's legs to be equal length. Nate said he wants to get back to a "normal" life. His dad,
Jeff, a clinical director at a crisis intervention center, competes in triathlons, and Nate used to participate in them as well.
"I just want to be able to jump around like everybody, be able to do stuff (and) walk without having to walk on my toe or
wearing a lift," Nate said.
Nate and his mom, Laura, a second-grade teacher in Canton, are staying at Quantum House, on the St. Mary's campus,
while he completes pool therapy at the Rehabilitation Center.
Like dozens of other families, the Allens followed Paley to West Palm Beach for surgery and are spending months away
from home during the limb-lengthening and/or limb-restoration process. Traveling to the Mayo Clinic for cancer surgery
and chemotherapy separated the family for weeks on end, and so is this process.
Laura Allen has only seen her husband and her other son, 10-year-old Matt, twice in the past eight weeks. "It's tough. There
are tears on the phone and that's hard to deal with. But this is for Nathaniel. We all know this. This is a family sacrifice."
"What he went through before, going through cancer was 10 times, 1,000 times worse than this," she said. "This isn't fun.
He doesn't like looking at this (fixator). He doesn't like knowing this goes directly in, but he knows that what he persevered
through before was life and death. This is to make his life more bearable ... He's had this period of being limited and now,
he's going to have his life back."
Direct link to this story
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Limb Lengthening.us
Dror Paley, MD, FRCSC
Dror Paley, MD, FRCSC
| ORTHOPEDIC EDUCATIONAL SITE BY THE MOST EXPERIENCED LIMB LENGTHENING SURGEON IN THE WORLD |