Terese Ney
(National) 410-601-5026
(International) 00+1+ 410-601-5026
tney@lifebridgehealth.org

Jill Bloom
(National) 410-601-5025
(International) 00+1+ 410-601-5025
jbloom@lifebridgehealth.org

For Immediate Release:
April 1, 2002

The Rubin Institute for Advanced Orthopedics at Sinai Hospital in Baltimore, Maryland, USA, is the location of the International Center for Limb Lengthening, the only center in the US completely dedicated to the correction of limb deformities. It is here that, Dror Paley, MD, FRCSC, performed surgery on Italian born, Federico, a 14 month old infant, who was born with a limb deformity.

Federico was born in Torino, Italy. A beautiful, healthy boy, and one of twins, Federico had a noticeable problem with one of his legs. His right leg and foot were shorter than the left and the bone was not straight but curved. The diagnosis: fibular hemimelia, a congenital limb deformity that occurs in one of 40,000 births and results in a shortening and curvature of the lower half of the leg.

In search of a medical solution for their child, Federico�s parents learned about limb lengthening: a surgical procedure that would correct their son�s deformity and grow the shortened bone. In Italy, limb lengthening for fibular hemimelia is done when the child is around 6 years of age.

Paley, an internationally recognized orthopedic surgeon in the US with over 15 years of experience correcting congenital limb deformities, performs this corrective surgery on children with Federico�s condition at a much younger age. We perform this surgery earlier because it is better tolerated and there is a better chance for a normal foot,� notes Paley. At the International Center for Limb Lengthening at Sinai Hospital of Baltimore, Paley and his partner, John E. Herzenberg, MD, have performed 120 surgeries for fibular hemimelia to this date and have published many articles on the subject.

This Italian family found Paley, who speaks fluent Italian, through the Internet. After much long distance communication, they decided to travel to Sinai Hospital in Baltimore, Maryland for this limb saving operation. The surgery, which lasted 7 hours, was performed at the end of January 2002 on the child�s right leg and was a complete success.

The surgery involved cutting the shortened bone in three places in order to straighten the curvature, and attaching an external apparatus in order to lengthen the bone. The apparatus, called a pediatric Ilizarov apparatus, is made of metal and it goes completely around the leg, fixing to the bone with metal pins. Its purpose is to control the bone grow or lengthening. Growth occurs when the patient or Federico�s parents in this case, turn a metal screw on the apparatus that pulls the bone apart, causing new bone to fill in its place. The apparatus was originally developed in Italy for use on dogs and cats. Paley was the first to start using this device to help children.

Federico�s parents turn the screws on the Ilizarov apparatus 3 times a day to cause the leg bone to lengthen. Since surgery, his leg has grown 4cm. The goal is 5cm of length. The Ilizarov apparatus will remain on Federico�s leg for approximately 2 more months.

With the Ilizarov fixture on his leg, Federico is able to play and walk, when assisted by his mother. Most children can walk with the device on if they learned to walk before the operation. Once lengthening is complete, the parents stop turning the screws and the fixture remains on Federico�s leg until the new bone becomes hard and strong. This usually takes about 2 months and is monitored with x-rays films. Once the bone is ready, surgery to remove the Ilizarov apparatus takes place and within a few week Federico will be walking and running around together with his twin brother with a completely normal leg.

This Italian family continues to travel back and forth from Italy for follow-up visits. Their next visit to Sinai Hospital in Baltimore will take place in approximately three weeks or the middle of April 2002.

Paley is the director of the Rubin Institute for Advanced Orthopedics at Sinai Hospital and the co-director of the International Center for Limb Lengthening (ICLL). He is internationally recognized for his expertise in limb lengthening and reconstruction. Paley trained under the guidance of Professor Ilizarov of Russia (Ilizarov method) as well as Dr. Cattaneo, Dr. Catagni and Professor Debastiani of Italy (Orthofix method). He is fluent in Italian and travels to Italy every year to give medical lectures.

In 1986, Paley introduced the Ilizarov method to the US and Canada. Since that time, he and his partners, Drs. Herzenberg and Janet Conway, have performed over 5,000 limb lengthening and reconstruction-related procedures on patients from all over the United States and from more than 40 countries.

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