The entire staff of Shriners Hospitals for Children – from researchers to nurses, physicians, clinicians and therapists – is committed to improving the lives of our patients. Here are some ways that our innovative care is fulfilling that mission.
Putting power in kids’ hands
Shriners Hospitals for Children leads the way in advanced technology in pediatric orthotics and prosthetics (POPS). For example, the POPS teams at the Salt Lake City and Chicago locations provide M-Fingers, an innovative device that helps children who are missing fingers attain the fine motor skills needed to accomplish daily tasks and have a better quality of life.
Hagen, 5, was fitted for an M-Fingers prosthesis at Shriners Hospitals for Children — Salt Lake City.
The POPS teams build artificial hand devices incorporating the M-Fingers, which are created by Partial Hand Solutions. The artificial hands are lightweight and durable and are controlled by a child’s own movement. This makes the fingers more responsive and precise. For example, the fingers can conform around objects to provide a secure grip.
Through wrist movements, this technology helps children navigate classroom activities and also promises to take playtime to new heights. Tasks like holding a pencil, picking up a piece of paper, playing with Legos, holding on while on a swing and other activities requiring fine motor skills become possible with M-Fingers.
Before M-Fingers, children who were missing fingers often chose not to get an artificial hand. The devices were heavy and uncomfortable to wear, while lighter-weight options provided limited functionality. These children would learn to adapt to everyday tasks without the use of their hand.
“It’s rewarding to be able to see kids reach their goals,” said Kelly Brooks, certified prosthetist and orthotist at Shriners Hospitals for Children — Salt Lake City, regarding the potential impact of M-Fingers on patients’ abilities.
Customizing care
Understanding each patient’s pain and disability allows Shriners Hospitals’ surgeons to practice innovative and tailor-made medicine.
Thierry Pauyo, M.D.
Mitchell Bernstein, M.D.
At Shriners Hospitals for Children — Canada, Thierry Pauyo, M.D., an orthopedic surgeon and sports medicine specialist, and Mitchell Bernstein, M.D., an orthopedic surgeon specializing in limb differences, have combined their expertise to customize patient care. The impact on patients has been immense.
“We are now looking at pain and disability objectively,” said Dr. Bernstein. “We are proving with patient-recorded outcomes that it’s not just that patients aren’t participating in sports, but they could also be unhappy or have a poor quality of life. What’s innovative is that we are targeting the pathology.”
At the hospital’s motion analysis center, patients are evaluated by a multidisciplinary team, which can include kinesiologists, physiotherapists, biomedical engineers and researchers. They use EOS imaging and 3D modeling to determine the specifics of each patient’s condition.
An example of this approach is the treatment of miserable malalignment syndrome, which causes an abnormal rotation of bones in the leg. Patients with this condition typically experience knee pain and can also have hip, ankle and back pain, as well as a different gait pattern. The multidisciplinary team uses motion analysis data to study what’s happening with the knee joint and determine the most appropriate treatment for each patient, said Louis-Nicolas Veilleux, Ph.D., principal investigator at the Canada hospital’s motion analysis center.
“If the femur is twisted, it can induce abnormally high pressure on a specific area of the knee,” he said. “If we find that the large rotations do not induce abnormal pressure points in the knee, we may look for an alternative to surgery to fix the problem.”
The innovative care Cameron received has allowed him to return to sports.
Cameron, 18, became a patient of Drs. Bernstein and Pauyo two years ago. “When I was in seventh grade, my knee kept dislocating while playing hockey and baseball,” Cameron said. He was referred to Shriners Hospitals, where they discovered that his femur was rotating outward. After EOS imaging, an MRI and other tests, he had surgery to turn his femur by 30 degrees and align his tibia. “Since then, life has been fantastic,” he said. “It is great to get back to normal and play basketball without any worry, problems or pain. I am looking forward to playing hockey again.”
Using breakthrough technologies
Advancing technology is another way Shriners Hospitals pursues innovative care. For example, virtual surgical planning tools developed in part at Shriners Hospitals for Children — Chicago, along with 3D printing, allow craniofacial surgeons to provide better outcomes for functions like breathing and eating, in addition to improving patients’ appearance.
One of the challenges of jaw surgery occurs when patients’ jaws don’t open and close correctly. Surgeons must envision a plan to achieve the best result. When plastic surgeons at our Chicago location needed more complex tools to plan jaw surgeries and complicated reconstructive surgeries, they developed their own platform – “virtual reality” surgery, or virtual surgical planning (VSP). This allows surgeons to virtually manipulate and even operate on a 3D version of the patient’s unique anatomy.
Dr. Morris uses “virtual reality” planning for craniofacial surgeries.
“We use VSP in planning myriad craniofacial cases in which we cut the facial bones and reposition them to improve facial proportion and facial symmetry, and to achieve a stable dental occlusion [how the teeth come together],” said David Morris, M.D., chief of plastic surgery. Cutting guides and splints (devices that hold a jaw in the corrected position during healing) are 3D-printed after virtual planning to use in the actual operation. The Chicago Shriners Hospital’s craniofacial team also 3D-prints teeth and skull models to help surgeons evaluate if the patient is ready for jaw surgery, or whether more orthodontic treatment or facial growth is needed.
Measures of success
Mike Mejia, outcomes coordinator at Shriners Hospitals for Children Medical Center — Lexington, shows a thoracic lumbar sacral orthosis (TLSO) brace that is ready to be fitted with a button-sized temperature monitoring device that will help patients and physicians track brace wear time.
Research has shown that patients with scoliosis who wear a brace for the prescribed amount of time – up to 23 hours a day – often see a significant difference in controlling their spinal curve. However, it’s not easy to do, and it’s difficult to track.
Shriners Hospitals for Children Medical Center — Lexington has implemented a brace compliance program to help objectively measure brace wear time, providing care teams with information about how patients with idiopathic scoliosis wear their braces, helping to improve outcomes.
Working within the recommendations of the Scoliosis Research Society (SRS) and the Shriners Hospitals for Children Spine Study Group, the medical team at the Lexington location began using temperature monitors in 2018 to collect and measure patients’ brace wear time.
This technology provides several benefits, which include:
- The patient and family do not have to record or remember how long and when the brace was worn. (Appointments are often six months apart, so it can be challenging to recall.)
- The temperature monitors provide specific and reliable information that can indicate progress, so care providers can make the best clinical decisions possible and provide support and encouragement.
- The reports help improve communication among the care provider, patient and family, which also helps improve outcomes.
At Shriners Hospitals for Children, innovation and research inform the treatment of each patient. Our multidisciplinary teams are dedicated to working together to continually improve outcomes for every child who comes to us for care.
