The Children’s of Alabama Limb Deformities Program is setting the standard in Alabama and beyond. (Stock photo)
Born with one leg shorter than the other, the young boy set two exciting goals after Children’s of Alabama chief of orthopedics Shawn Gilbert, M.D., corrected his condition with leg-lengthening surgery. The first was to buy a pair of “cool” sneakers that didn’t require lifts to align his gait; the second was to learn to ride a bike, which he couldn’t manage before.
Two decades later, Gilbert still keeps updates the boy’s parents sent him through the years, grateful for how their son’s life was transformed. It’s just one example of the thousands of young patients who have benefited from Children’s Limb Deformities Program, which launched after Gilbert’s arrival in 2003 and is now recognized for its deep expertise across Alabama and the globe.
“I often tell patients that limb-lengthening surgery is my favorite kind of surgery to do, because I still can’t believe it works,” said Gilbert, who’s also a professor of surgery in the Division of Orthopedic Surgery at University of Alabama at Birmingham (UAB). “Essentially what you’re doing is dividing a bone and stretching it apart, then watching it fill in with new bone in the gap. The whole process, to me, is really amazing and never gets old.”
Gilbert’s fascination with the field has helped cultivate a similar mindset among the department, which includes seven orthopedic surgeons—more than the total number of pediatric orthopedic surgeons in the rest of Alabama. Serving patients with conditions that include bone diseases and dysplasias like rickets and achondroplasia, Blount’s (a disorder in the growth plates in the bones around the knee), and undeveloped limbs, the program offers both surgical and non-surgical treatments for these children, whose mobility and morale can both suffer because of their differences.
About 140 young patients are enrolled in Children’s Limb Deficiency Clinic, which joins specialists from orthopedics and rehabilitation medicine to serve patients with amputations and other limb deformities.
“Some children have milder angular deformities (such as knock knees or bowed legs) that might not create a big functional deficit, but might be pretty noticeable,” Gilbert said. “Many parents report their children are teased or bullied on account of that. If their issue is bigger, they may need assistive devices, prostheses, or even be unable to walk and need a wheelchair.”
Surgical correction is the approach for 30-50 patients at Children’s each year, most of whom have limb deformities. Many patients are referred from other institutions across the state because of Children’s of Alabama’s reputation.
Gilbert, who has held leadership positions in state and national orthopedic organizations, recently spoke in China at a global conference focused on trauma repair, limb deformity correction, limb lengthening and limb reconstruction. “That’s one of the ways we’re recognized for our expertise in this area,” he said.
Now performing more pediatric limb reconstructions than anyone else in the Alabama, Children’s orthopedic surgeons would next like to examine how patient outcomes might be harmed by inequities in access to care. Since limb deformity treatments—especially lengthening procedures—involve a great many medical visits over a longer period of time, “there’s a big burden of care on the families, and having the resources to help with that is really important,” Gilbert said.