Since 1950, Nicklaus Children’s Hospital has been home to a wide range of specialists who collaborate to meet the orthopedic care needs of pediatric patients. These efforts have led to multiple awards and recognitions, including the Pediatric, Orthopedic, Sports Medicine & Spine Institute being named one of America’s best pediatric orthopedic programs by U.S. News & World Report.
Inside the Institute, more than 10 orthopedic surgeons perform over 1,400 surgeries and 40,000 outpatient consultations at locations throughout Miami-Dade, Broward and Palm Beach counties each year. Procedures range from standard fracture care to innovative approaches, such as bridge enhanced ACL restoration (BEAR implants), and extend into experimental treatments through clinical trials.
Working alongside this team of surgeons is a highly trained team of bilingual orthopedic technicians, advanced practice practitioners, residents, fellows and more. Together, they help restore mobility and quality of life for children of all backgrounds and abilities, each with a unique story. Here are the stories of two children who benefited from these services.
From Leg-Lengthening to Serving Others
Born at 33 weeks gestation, Luciana arrived with both ventricular and atrial septal defects. Once these heart conditions were remedied, the infant was identified as having disproportionate legs and feet. At the age of 3 years, Luciana visited the team at Nicklaus Children’s to move a foot tendon in order to walk straight. Soon after, a heel surgery served to straighten her foot.
Even with these notable improvements, one of Luciana’s legs remained more than an inch longer than the other. This caused hip and leg discomfort after walking or standing for a prolonged period, a constant limp that Luciana worked hard to disguise and the need to occasionally take additional steps to maintain a consistent walking pace.
For Avi Baitner, MD, pediatric orthopedic surgeon at Nicklaus Children’s, the question he asked upon meeting Luciana in 2021 was, “How do we get those legs to be as equal as possible?”
After some consideration, Dr. Baitner determined internal fixation was appropriate over the ILIZAROV technique. Internal fixation follows the same principle as external, with the surgeon initially breaking the bone to permit lengthening of the bone. Dr. Baitner inserted the fixation device inside Luciana’s tibia. A special magnet connected to gears that slowly lengthened an integrated rod and subsequently, Luciana’s tibia.
After living with pain and limping for much of her life, Luciana experienced significant benefit from the limb-lengthening procedure. Seeking to help other teens and children facing the same surgery, she created Rise Above: A Teen’s Guide to Limb Lengthening Surgery: Physical and Mental Tips for a Healthy and Happy Journey.
Though created to help her peers across the world, Luciana’s work has inspired and encouraged her medical team at Nicklaus Children’s.
“The fact that she’s willing to go out there and take a little of herself and pay it forward,” Dr. Baitner says, “I think that light is going to shine for decades.”
Helping Santi Thrive
Seven-year-old Santi was born with SMARD1. A rare neuromuscular disorder, SMARD1 is rooted in IGHMBP2 gene mutations and results in frequent respiratory infection and bone and muscle weakness. Unable to move his limbs or hold his neck upright, Santi requires a multidisciplinary team to help him enjoy the highest possible quality of life.
Orthopedic specialists at Nicklaus Children’s have served him from day one, working to meet his unique needs. They fit him with special boots to maintain the shape of his feet and work to address the inherent progression of spinal motor degeneration. These orthopedic experts work alongside a team of specialists that include pediatric neurologists, geneticists, nutritionists, ophthalmologists and others.
Despite the daily challenges Santi faces, he makes the most of every day, frequently calling nurses at Nicklaus Children’s to ask how their days are going.
“Santi is an inspiration to us all,” says Migvis Monduy, MD, pediatric neurologist and Medical Director of the Neuromuscular and Movement Disorders Programs at Nicklaus Children’s. “He is always a joyful little boy who is happy to talk to anyone he meets.”
Email a Nicklaus Children’s physician liaison to refer a patient for orthopedic care at Nicklaus Children’s Pediatric, Orthopedic, Sports Medicine & Spine Institute.
