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Complex Case | Overview

Each “Complex Case” in Boston Children’s Orthopedics and Sports Medicine Advancing Orthopedics newsletter details the complexities of a surgical procedure or treatment plan for a patient with a particularly complicated condition or injury.

Humeral lengthening using a lower extremity device

An 8-year-old patient’s left proximal humerus unicameral bone cyst treatment took place at Boston Children’s Hospital starting in 2009. As a result of the cyst and subsequent bone grafting, he developed a growth arrest. By age 18, the patient’s left arm was 14 centimeters shorter than his right. In 2019 and 2020, when the patient was 18 and 19 years old, orthopedic surgeon Carley Vuillermin, MBBS, MPH, FRACS, used the PRECICE internal limb-lengthening system to lengthen the patient’s left humerus by five centimeters each summer for a total lengthening of 10 centimeters.

Advanced instrumentation for atlantoaxial instability in a 2-year-old child

Pediatric orthopedic surgeon Daniel Hedequist, MD, and neurosurgeon-in-chief Mark Proctor, MD, performed a revision skull-to-C2 fusion using modern instrumentation on a 2-year-old girl with Down syndrome and ongoing spinal cord injury.

Nerve transfers for acute flaccid myelitis

Orthopedic surgeons Andrea Bauer, MD and Peter Waters, MD, successfully performed a partial radial to axillary nerve transfer on a 5-year-old patient who contracted a rare but increasingly common polio-like illness that affects the nervous system in the spinal cord.

Surgical management and decision-making for a traumatic growth plate injury

Pediatric orthopedic surgeon Collin May, MD, MPH, performed a hemiepiphysiodesis procedure on a 12-year-old with a growth deformity due to a traumatic leg injury. The variety of surgical options the patient family has to choose from as their child continues to grow makes the decision-making behind this case both unique and challenging.

Treating a pelvic ischial tuberosity fracture

Orthopedic surgeon and sports medicine specialist Benton Heyworth, MD, details the shared decision-making process of non-operative versus operative treatment for this rare injury in a track athlete.

3-D printing the pre-op plan for PAO

Pediatric hip specialist Travis Matheney, MD, MLA utilized 3-D printing technology in pre-op planning a PAO for a patient with hip dysplasia and femoral acetabular impingement.