Our orthopedic surgeons specialize in advanced orthopedic surgeries that cover the entire orthopedic surgical spectrum. These specialized surgeries include spine deformities & scoliosis, hip deformities & reconstruction, hand & upper extremities and foot & lower extremities surgeries.

Spine Surgical Treatment

The most common type of spine surgical treatment is for scoliosis. Children who have spinal curves greater than 40 to 50 degrees are often considered for scoliosis surgery. Factors considered for recommending surgery include how mature the child’s bones are and the curve's rate of progression. While surgery will not perfectly straighten the spine, the goal is to make sure the curve does not get worse. Scoliosis surgeries are done while children are under anesthesia.

Posterior instrumentation and spinal fusion

This is the most common scoliosis surgery, where the orthopedic surgeon performs a spinal fusion through the child’s back. A spinal fusion is when the vertebrae are fused together so the spine cannot bend. Metal implants (usually rods, screws, hooks or wires) are put in to hold the spine in place while the vertebrae gradually fuse. The procedure usually takes four to six hours, but varies from patient to patient. The implants are left in the body, even after the bones have fused, to avoid additional surgery.

Anterior instrumentation and arthrodesis

Certain types of curves that need correction in the lower spine, and that are stiff and have poor spinal balance, are best corrected with anteriorly (spinal fusion from the front of the patient). The advantage of anterior surgery is that with a complete discectomy (disc removal), stabilizing the spine with metal rods and performing fusion become a highly successful way of correcting the child's deformity.

Anterior spinal release

When the spine deformity is rigid it does not respond as well to spinal fusion surgery. Anterior release can be done through an open surgical procedure or through an endoscope. The intervertebral discs and restricting ligaments can be surgically removed, so that the stiffness of the deformity is relaxed through the side of the chest.

Thoracoplasty

Scoliosis can make a "rib hump," a prominent elevation of the ribs. A “rib hump” can be corrected during the spinal correction by cutting out the deformed ribs and re-shaping them.

Hip Deformities & Reconstruction Surgical Treatment

Persistent hip symptoms can lead to hip damage, because wearing out of cartilage inside the hip joint becomes permanent. Corrective surgery can treat a hip abnormality. Surgery is performed in the surgical center under anesthesia.

Osteoplasty/bone grafting

This is the most common form of treatment for an aneurysmal bone cyst, where orthopedic surgeons scrape the cyst out of the bone with a curette. The remaining cavity is then packed with donor bone tissue or bone chips taken from another bone.

Total hip arthroplasty (THA)

This is a surgical procedure in which the hip joint is replaced by a prosthetic implant in a child. This joint replacement surgery is generally used to fix severe physical joint damage as part of hip fracture treatment.

Hip reconstruction surgery

Hip reconstruction is a specialized approach to treating pediatric hip and pelvic disorders, coordinating surgical procedures and intensive post-operative rehab to optimize motion and function. Leading hip reconstruction surgery can postpone the need for hip replacement surgery (hip arthroplasty) or eliminate it all together, such as:

  • Hip Arthroscopy: An arthroscopy is a non-invasive technique for treating secondary problems inside the hip. During this 30-minute outpatient surgical procedure, small holes are placed in the patient’s hip and a tiny camera is inserted that projects the image of the hip on video screens in operating rooms. The orthopedic surgeon “cleans out” the frayed lining and inflammation in the hip to prevent further joint deterioration.
  • Periacetabular Osteotomy (PAO): This procedure preserves and improves the function of the patient's own hip joint rather than replacing it with an artificial one, and is the primary surgical correction for acetabular dysplasia. A PAO involves rotating the shallow dysplastic acetabulum (socket in pelvis) by cutting it free from within the pelvis so that it can be repositioned into a more stable alignment on the top of the head of the femur. This re-alignment allows pressure to be more evenly distributed, eliminating pain and restores hip function.
  • Surgical Dislocation of the Hip: The surgical dislocation approach is useful in effectively assessing and treating proximal femoral hip deformities, commonly seen in kids, and improve short-term symptoms.

Hand & Upper Extremities Surgical Treatment

Surgical correction can begin on your child when casting no longer improves the condition, often as early as three months of age. Pediatric orthopedics also provides consultation and surgical care to children with neuromuscular disorders. Surgery is performed under anesthesia. Surgery may include:

Hand reconstructive surgery

Orthopedic surgeons perform reconstructive and cosmetic surgery procedures for congenital and developmental anomalies of the hand, such as syndactyly (webbed fingers) and polydactyly (extra finger).

Microvascular surgery

Surgery on blood vessels that only three to five millimeters in diameter. Microvascular surgery is done through an operating-room microscope using specialized instruments and tiny needles, on very small blood vessels. Microvascular surgery is used to re-attach severed fingers, hands, arms and other amputated parts of the body by reconnecting the small blood vessels and restoring the circulation before the tissue starts to die.

Tendon repairs

Repair of tendons, fibers that attach muscle to bone, are classified as primary and secondary. Primary repairs usually involve direct surgical correction of the injury. Tendon injuries can occur due to infection, trauma, or spontaneous rupture. Secondary is when the tendon is actually transferred.

Tendon transfers

Tendon transfer surgery, or secondary tendon repair, is a type of hand surgery that is performed in order to improve lost hand function. A functioning tendon is shifted from its original attachment to a new one to restore lost hand action.

Distraction lengthening

This is a form of reconstructive thumb or finger surgery, which usually takes multiple surgeries, to lengthen the digits on a hand.

Upper limb lengthening and reconstruction

Customized treatment for children with limb discrepancy or severe deformities. Complex surgical techniques restore normal limb length and alignment.

Foot & Lower Extremities Surgical Treatment

Advanced surgical techniques are used to restore foot function and correct foot and limb deformity and deficiency. Surgical correction can begin on your child when casting no longer improves the condition, often as early as three months of age. Surgery may include:

Soft tissue and ligament releases

Orthopedic surgeons use surgery to release soft tissue or ligaments that are causing the patient severe pain.

Tendon transfers

Tendon transfer surgery, or secondary tendon repair, is a type of foot surgery that is performed in order to improve foot functionality. A functioning tendon is shifted from its original attachment to a new one to restore lost foot action.

Bone grafting

Bone grafting is a surgical procedure that replaces missing bone with material from the patient's own body, an artificial, synthetic or natural substitute. Bone grafting is used to repair bone fractures that are extremely complex.

Foot reconstructive surgery

Orthopedic surgeons perform reconstructive and cosmetic surgery procedures for congenital and developmental anomalies of the foot.

External fixation

External fixation is a surgical treatment used to set bone fractures, where a cast would not allow proper alignment of the fracture. Holes are drilled into uninjured areas of bones around the fracture and special bolts or wires are screwed into the holes. Outside the body, a rod or a curved piece of metal with special ball-and-socket joints joins the bolts to make a rigid support.

Lower limb lengthening and reconstruction

Customized treatment for children with limb discrepancy or severe deformities. Complex surgical techniques restore normal limb length and alignment.

Club Foot Treatment

Surgical management is required in approximately 10 percent of club feet with tendon and capsular releases of the bone. Surgery for club foot is involves adjusting the tendons, ligaments and joints in the foot and ankle to keep it in a corrected position. After surgery, a custom-made cast or brace may be used to allow the child's foot to grow while still staying in alignment.

Sports Medicine Surgical Treatment

For patients who have reached skeletal maturity, some surgical options are available. The pediatric orthopedic care team analyzes the injury site to choose the best treatment method for each individual patient. The most common type of surgery is sports injury reconstruction using arthroscopic techniques.

Anterior cruciate reconstruction

This is a surgical option for adolescents with more mature bones. Treatment for cruciate reconstruction involves surgical arthroscopy, which uses small incisions to create minimal trauma to the knee. In a torn ACL, this technique is used and a new ligament is used to replace the torn one.

Surgical arthroscopy for meniscus tears

Sometimes surgery is the only option for meniscus tears. A surgical arthroscopic procedure is used to make small incisions that create minimal trauma to the knee. Repairable portions of the meniscus are fixed with sutures or with a material that holds the meniscus together while the meniscus is healing.