Great start to the week with another fantastic East Coast stop, this time semi-local for us both - just up I-95 to Delaware. Dr. Reid Nichols started the week with a lovely get together at her home with the Nemours team and some of the folks from the Shriners in Philly and CHOP who we will see later this week.
We spent time with Dr Nichols doing some foot and ankle cases on our first day with an entire room full of female orthopedic surgeons! Not bad representation for our 6% 😉 We also got to spend some time with Dr Franzone and Kruse in the OI multidisciplinary clinic with a huge spectrum of ages and involvement. Megan and I are both more than a little jealous of the gait lab and the cafeteria!
Dr Mackenzie shared his vast spectrum of knowledge on skeletal dysplasias while we discussed the nuances of growth modulation. Despite neither of us doing spine, we both had to admit that the thorascopic anterior spine release we saw was pretty cool too.
Thanks to the team at duPont for their warm welcome! The commitment to multidisciplinary care for highly complex patients is inspiring and definitely sets a high standard. We can see why the patients love it there.
We spent the next 3 days hopping from one hospital to another in Philly. Dr Joe Rosenblatt greeted us for coffee and indications conference at St Christopher’s. We had a good time in the OR observing a frame application for infantile tibia vara. Joe reviewed the TLHex program for preop and postop planning and correction including the new iphone app.
Next stop ... Shriners Hospital. Claire and I enjoyed learning about the history of the hospital. We were so intrigued by Dr Van Bosse’s techniques for capsularbreleases and gradual correction of knee flexion contractures. We asked lots of questions so Dr Van Bosse agreed to review his approach to hip, knee and foot contractures for arthrogrypotic patients in lecture format. We learned a ton about how to optimize function for this special group of patients. We continued our discussions at the lovely Van Bosse home over cocktails and appetizers. Mrs Van Bosse whippednup an amazing meal. The Davidson’s joined us for dinner and we shared stories about life, travels, family, and careers.
We ended the week at CHOP with a MAC tutorial and deformity planning. What an impressive hospital!
Welcome to the Big Apple! The food is amazing...and the surgery too! We started off our first day with a bang...two big cases with Dr. Rozbruch... Miserable Malalignment... two derotational osteotomies and nailings...then we went on to do osteotomies and an all encompassing Ilizarov/Taylor Spatial Frame that spanned from the femur to the foot with femoral and tibial osteotomies! Big day in the Big Apple! P.S. Paul brought his family, and his son is loving the bagels here!
We all took a break from an “insanely busy week” to enjoy an entertaining evening and amazing dinner at the Palm Beach Yacht Club where the conversation was anything but orthopedics. Unfortunately Dr Feldman was the photographer and missed our group photo!
What a whirlwind of a week. We observed over 25 cases at the Paley Institute. Preop conference indicated that next week will be just as “insanely busy”. Megan was excited to finally see a “Super Knee” and “Super Ankle” procedure but will have to return to Palm Beach for the full trifecta to include the “Super Hip”. Claire is gearing up for a radial club hand extravaganza during her upcoming trip to Poland with Dr Paley and learned that she will also be the new RPQ (otherwise known as the Rotationplasty Queen). We learned various ways to insert PRECICE nails both inside and outside of the bone!
We joined Dr Paleys entourage for Friday morning rounds which include a team of nurses, PAs, fellows, therapists, case managers, and interpreters. We were rewarded at the end of a busy operative week with smiles from all of the patients. This is a picture of the scenic route back to the Paley Institute.
We finished off the week with a bang! Just 40 patients in the office with the most complex congenital deficiencies, deformities and leg length discrepancies of various etiologies. Our heads were spinning at the end of the day. Dr Paley somehow managed to educate us about each patient, address countless questions from family members and connect personally with every patient.
As we walked out of the hospital after a fantastic week this banner hung over our heads. The saying could not be more true. We witnessed so many families from around the world express eternal gratitude for the skill and care the surgeons and team at the Paley Institute offered their child.
Now off to the next stop .... Dupont!
Exciting couple of days for the Adult Fellows. We started off Thursday with a wonderful nonunion/deformity case in the femur, utilizing a plate/nailing combo using a precise nail. Then we made it to clinic for the afternoon and then off to Dallas to the Limb Restoration Forum. Lot's of good discussion, cases and comradery. Shown above, Paul, one of the adult fellows, presenting a case to a very distinguished group of faculty: Tracy Watson, MD, Jim Binski, MD, Paul Freudigman, MD, Phillip McClure, MD, Stephen Quinnan, MD. Intimidating, but immensely helpful. Next stop...NYC!
Whoa! High yield clinic with Dr. Quinnan for Paul and me! Saw about 20-25 patients in the morning ranging from simple midshaft tibia fractures to bilateral 100+ deg knee flexion contractures treated with circular external fixators. We got to discuss the intricacies and subtleties of many of the bone transport and multifocal deformity patients. All in all, he runs a very happy clinic and his patients are extremely appreciative. Probably no blog tomorrow as we do a quick case in the morning followed by a short clinic and then we're all off to the Limb Restoration Forum in Dallas.
It’s been a busy week already at the Paley Institute so we are a little behind our adult colleagues with this blog...we think we counted 14 cases in the last 2 days alone! Everything from lengthening to radial club hand to <90 degree congenital contractures. I think we are both a little jealous of the variety of diagnoses and great outcomes we saw in clinic from all the incredible surgeons here.
”the nerves are our friends: we come and say hello, don’t overstay our welcome, and then leave them to their own business.”
It’s been a little stormy here, but the power outages certainly didn’t stop the OR from running or sitting down to review cases with Dr Paley with a lovely view of the lightning.
Another incredible day! The highlight was for sure watching a patient with bilateral open tibias (plateau on one side, open pilon the other) get set up in preparation for a flap and later cable transport. We came full circle to finish the day with a saw bones lab...learning to do cable transport hands-on. So much to learn and too much to write down.
-Paul, James - 2019 Adult Traveling Fellows
What a first day! Good morning Miami! We started the day with Dr. Quinnan at the Ryder Trauma Center. A good mix of acute trauma and reconstruction. James and I are super excited! First...temporary external fixation/traveling traction for an open tibia, then cable transport, then techniques for nailing through a frame, then just for fun, lumbopelvic fixation! Great first day, informational overload!
-Paul, James 2019 traveling fellows