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David S. Feldman, MD - Pediatric Orthopedic Surgeon
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Jordan was born with skeletal issues which included low muscle tone, absent clavicles, and congenital kyphosis. He was later diagnosed with cleidocranial dysostosis, a rare hereditary congenital disorder which causes teeth and bones in the upper torso to develop abnormally. At the age of 13, Jordan’s spine had developed multiple #hemivertebrae in addition to #scoliosis and #kyphosis curves.
 
Jordan underwent a posterior spinal fusion with Ponte osteotomies to help straighten his spine and expand his ribs. He did very well after surgery and was able to return to playing basketball five months after surgery.
 
http://www.davidsfeldmanmd.com/patient-education/case-studies/jordan-cleidocranial-dysostosis
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At the age of 23, Christopher a young man with left hemiplegic cerebral palsy visited me for an evaluation of right knee pain which began eight years prior without any known injury. Christopher was unable to walk independently, had a history of lower limb issues, and had undergone several surgeries prior to and after the occurrence of his knee pain. I found that a combination of a crouched gait, hip contracture, and knee contractures were causing his knee pain.
 
A series of tenotomies, osteotomies, and a trochlear replacement relieved his pain and improved his ability to walk.
 
http://www.davidsfeldmanmd.com/patient-education/case-studies/christopher-knee-pain-crouch-gait-hip-flexion-contracture

#kneepain #hipcontracture #osteotomy  
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Nathalie was diagnosed with osteogenesis imperfecta (Type IV) as a toddler. Osteogenesis imperfecta is a congenital genetic condition that causes brittle bones which fracture easily from minor impact and in some cases for no reason. As a result, Nathalie experienced multiple fractures throughout her childhood which required several surgical procedures.
 
Given the nature of osteogenesis imperfecta, these childhood fractures were to be expected. However, Nathalie’s parents’ diligence in immediately seeking care has helped to limit the long-term effects that could have resulted from her injuries. Nathalie is now in her early teens and doing very well overall.
 
http://www.davidsfeldmanmd.com/patient-education/case-studies/nathalie-osteogenesis-imperfecta

#osteogenesisimperfecta #brittlebonedisease #fractures  
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Shaunak was diagnosed at birth with #achondroplasia, a bone growth disorder that causes a form of #dwarfism. Shortly before his sixth birthday, he visited my office with his family to discuss options for limb lengthening and correction of his bowed legs. Shaunak’s limb deformities were corrected in stages over the course of eight months.
 
Shortly before his 14th birthday we discussed options for additional lengthening and the correction of a deformity that occurred as he grew. This course of treatment is still in progress and Shaunak’s case study will be updated once treatment is complete.
 
http://www.davidsfeldmanmd.com/patient-education/case-studies/shaunak-achondroplasia-bowed-legs
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Charlotte, a teen patient who has been under my care for a rare disorder since early childhood was recently featured in a story by ABCNews.com. At the age of 13, Charlotte underwent a limb-lengthening procedure which required her to wear a large spatial frame that made it impossible to wear regular pants. Charlotte decided to create her own clothing with snaps on the side rather than wear tear-away sweatpants.

Charlotte's procedure was successful and allowed her to participate in sports and other activities. Her experience motivated her to later launch "No Guts No Glory" (www.crnogutsnoglory.com), a clothing line that offers options for teens who have to wear external frames.

http://abcn.ws/1sBUAJe

#limblengthening

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David is an avid hiker who fell and fractured his femoral neck during a hike. He underwent a successful surgery which fixed his femoral neck but later developed avascular necrosis of the hip. I ultimately recommended a multi-faceted course of treatment that included bisphosphonates, core decompression, BMP/Calcium phosphate, and arthrodiastasis. This course of treatment has successfully resolved his avascular necrosis of the hip and prevented the collapse of his femoral head.
 
http://www.davidsfeldmanmd.com/patient-education/case-studies/david-femoral-neck-fracture-w-avascular-necrosis-hip

#femoralneckfracture #avascularnecrosiship #coredecompression  
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After six years of intermittent groin pain, Nadine sought medical care when her symptoms became worse. An MRI revealed a cartilage tear in her right hip and she was later diagnosed with bilateral hip dysplasia. When Nadine visited me for a second opinion, I found that her right hip was worse than her left and recommended a right hip periacetabular (Ganz) osteotomy.
 
In the months since her surgery, Nadine’s right hip pain has been resolved and she’s been able to return to her normal activities.
 
http://www.davidsfeldmanmd.com/patient-education/case-studies/nadine-hip-dysplasia

#hipdysplasia #ganzosteotomy #periacetabularosteotomy  
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Vincenzo is a young man from Bari, Italy who had been diagnosed with arthrogryposis at birth and had been wheelchair bound since the age of six. His family had sought treatment in Altamura and Milano Italy but doctors had not provided any treatment and told the family that nothing could be done to improve his condition. At age 14, he traveled with his family to America to seek treatment.
 
During our consultation I found that while Vincenzo’s arthrogryposis had caused severe contractures and lower limb deformities, many of these issues could be resolved with surgery and therapy. Over the course of two years, I performed muscle and tendon releases to allow for improved range of motion. By the end of treatment, Vincenzo was able to walk without assistance and had greater control of his arms which allowed him to use his hands in ways he could not before.  
 
http://www.davidsfeldmanmd.com/patient-education/case-studies/vincenzo-arthrogryposis-lower-limb-deformity-contractures-pterygium

#lowerlimbdeformity #arthrogryposis #contractures  
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Francesca is a competitive level female gymnast who sustained a proximal tibia fracture at the age of 10. The injury damaged her growth plate (physis) which caused it to close prematurely and led to the development of deformities where her right leg was shorter than her left and her right knee bent backwards 16 degrees more than her left knee. Francesca underwent a proximal tibia fibular osteotomy surgical procedure and had a Taylor Spatial Frame applied to her leg. The combination of this surgical procedure with physical therapy resolved her lower limb issues and allowed her to return to gymnastic.
 
Francesca recently qualified for Nationals and will be competing in the next few days. We wish her the best of luck and we’ll all be rooting for her!
 
http://www.davidsfeldmanmd.com/patient-education/case-studies/francesca-anterior-physeal-arrest-recurvatum-deformity-shortening

#osteotomy #growthplateinjury #recurvatum  
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Adult hip dysplasia describes a condition where the hip’s ball (femoral head) and socket (acetabulum) are misaligned. The condition is common in children but is also found in adolescents and adults who have had no history of problems in childhood. Treatment options include temporizing with medication and/or physical therapy but surgery is often required to fix the problem.

Adult hip dysplasia ranges from mild to severe and can affect one or both hips. A dysplastic hip socket typically causes discomfort and pain beginning in late adolescence and gradually becomes worse over time. A shallow acetabulum may develop during infancy but may not be evident until after puberty and may not cause pain until the teen years or later.

Common symptoms of adult hip dysplasia include:

- Abnormal positioning or turning of the legs
- Decreased range of motion on the side where the hip is partially (subluxed) or fully dislocated
- The leg may appear shorter on the side where the hip is partially (subluxed) or fully dislocated
- A limp if one hip joint is affected or waddle if both hip joints are affected. However, an abnormal gait might be more difficult to detect if both hips are dislocated.
- Undiagnosed hip dysplasia may result in osteoarthritis

http://www.davidsfeldmanmd.com/specialties/adult-hip-dysplasia
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