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"For instance, some spine surgeries that we would traditionally have performed from both the back and the front are now being performed exclusively from the back," explains Dr. Son-Hing, who is involved in evaluating the effectiveness of certain pediat- ric orthopaedic procedures. "By not performing a thoracotomy, for example, you stay away from violating the lungs." For pediatric athletes, Rainbow offers the services of two board-certifi ed pediatric sports medicine specialists — Dr. Briskin and Dr. Weiss Kelly — along with orthopaedic surgeon Dr. Gilmore who focuses on surgical treatments of sport injuries. Dr. Briskin completed her fellowship training in Sports Medicine at Akron Children's Hospital; Dr. Weiss Kelly, at UCLA. Dr. Gilmore was fellowship trained in pediatric orthopaedic surgery at UH Rainbow. "Children don't heal the same way that adults do," says Dr. Gilmore. "Their bones tend to heal faster than adults', and they regain their range of motion and strength faster. So that makes a difference in the way we manage their care." She cites as an example a treatment for anterior cruciate ligament (ACL) injuries. In the past, ACL injuries in very young children were 'braced' and surgery postponed until the child was more skeletally mature. Now, Dr. Gilmore and her colleagues perform an extra-articular physeal sparing procedure which uses the patient's own tissue to stabilize the knee without drilling across the growth plate and risking growth arrest. "The use of absorbable screws and repair techniques that All of UH Rainbow's pediatric orthopaedic physicians are fellowship trained. Allison Gilmore, MD, (shown here) was fellowship trained in pediatric orthopaedic surgery. Her specialty is surgical treatments of sport injuries. preserve the patients' own cartilage can also help minimize trauma to young bodies," she says. "Using absorbable screws means that these patients don't have to have an additional surgery to remove the screws." Dr. Thompson points out that every procedure is performed Connecticut. Dr. Hardesty, completed her fellowship training at UH Rainbow and received additional training at the A.I. DuPont Institute. She is the newest physician member of UH Rainbow's pediatric orthopaedic team. "We offer regularly scheduled clinics for patients with diseases such as myelodysplasia, cerebral palsy and muscular dystrophy," says Dr. Thompson. "Clinics for patients with osteogenesis imperfect (brittle bone disease) and hemophilia are also offered on a regular basis." Bone cancer is the special focus of Dr. Getty, who was fellow- ship trained at the University of Chicago Medical Center. He is director of the Musculoskeletal Surgical Oncology program at UH and treats children with benign, as well as malignant, tumor-related orthopaedic problems. Dr. Lacey is UH's director of Hand and Upper Extremity Surgery and handles pediatric upper extremity cases at UH Rainbow. He was fellowship trained in hand surgery at Hartford Hospital in Connecticut. Dr. Liu specializes in limb lengthening procedures and complex osteotomies. He completed his pediatric orthopaedic fellowship at Rady Children's Hospital in San Diego. Rainbow's pediatric orthopaedic surgeons utilize minimally invasive techniques whenever possible to reduce risk, pain, scarring and blood loss. 30 | Cleveland-Akron-Canton MD NEWS MDNEWS.COM NOVEMBER-DECEMBER 2011 with a view toward its impact for patients both now and in the future. "Many times, what we do in pediatric orthopedics isn't for today, it's for tomorrow," he says. "A condition may not be causing a major problem now. But if I can alter the natural progression of a disease, it can make a huge difference in how that child is going to grow and develop, how much pain and disability they may have, and the overall quality of their lives in the future." Ongoing Active Research Due to Rainbow's high orthopaedic patient volume, an extensive database of patient information has been devel- oped. This database supports the physicians and research scientists in their pursuit of evidence-based pediatric orthopaedic care. "We now have a pediatric orthopedic spinal deformity database with almost 2,000 patients going back to 1992," says Dr. Thompson. "Having this kind of information allows us to easily obtain immediate information such as how many ml of pain meds were most effective at controlling pain, how much blood was lost during surgery, etc. We can query this database and generate valuable studies that help us continue to improve pediatric orthopaedic care." PHOTO COURTESY OF UNIVERSITY HOSPITALS