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corrective treatments, some of which these two doctors pioneered. In Ohio and Pennsylvania, they see many Old Order Amish who are more prone to skeletal dysplasia than the general population. These people suffer in particular from serious knee deformities caused by Ellis–van Creveld (EVC) syndrome and cartilage-hair hypoplasia, which causes short-limb dwarfism. Akron Children's is a recognized authority on these disorders. Brachial Plexus Palsy Clinic The Brachial Plexus Palsy (BPP) Clinic is co-directed by Dr. Adamczyk; Dr. Peter Letourneau, a pediatric plastic and reconstructive surgeon; and Dr. Suneet Sahgal, a pediatric physiatrist. Pediatric neurosurgeons and physical and occupational therapists are also part of the team. "BPP is nerve damage that affects a patient's arm movement and function," Dr. Adamczyk explains. "In the past five or six years, we've seen close to 100 patients, ages newborn to 16. For newborns, we confirm the diagnosis to rule out other possible causes of apparent arm weakness. These include a fracture sustained at birth or infection in the shoulder." He reports that most babies with BPP recover good arm movement and function. Constraint-based therapy restricts the use of the stronger arm, encouraging the baby to use the weaker arm more fully. And Botox injections and casting can help the healing process, as well. If the problem doesn't resolve, a brachial plexus repair or nerve transfer may be indicated, which are best performed at 6 to 9 months of age. Children ages 2 to 6 who have not had success with physical or occupational therapy may require a tendon transfer. "Most surgical treatments are offered for the very young," says Dr. Adamczyk. "With older kids, we prescribe therapy to help them learn how to perform some of the things they're having trouble doing." Club Foot Clinic Dr. Adamczyk also directs the Club Foot Clinic. While most of the orthopedic team treats children with this disorder, Dr. Adamczyk has a special interest in it. He trained with Dr. Ignacio Ponseti at the University of Iowa to learn the Ponseti Method, reportedly the "gold standard" of treatment for congenital clubfoot. "In the past, 70 to 80 percent of babies with club foot required an extensive surgery, Dr. Jones says. "And it worked pretty well short-term, but long-term results were quite poor. Many children's feet were overcorrected, or the surgery resulted in a stiff ankle or foot." PHOTOS © SMITHBERGER PHOTOGRAPHY, NORTH CANTON Dr. Kerwyn Jones is Chairman of the Akron Children's Hospital Department of Pediatric Orthopedics. SEPTEMBER- OCTOBER 2013 I MDNEWS.COM I MD NEWS Cleveland/Akron/Canton | 17