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Limb Lengthening.us
Dror Paley, MD, FRCSC
Dror Paley, MD, FRCSC
| ORTHOPEDIC EDUCATIONAL SITE BY THE MOST EXPERIENCED LIMB LENGTHENING SURGEON IN THE WORLD |
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ANNOUNCEMENTS
Dr. Paley’s lectures in the United States and abroad:
March 12, 2011
Dr. Paley and the Paley Foundation team returns to Haiti one year later on another humanitarian mission. Click Here to read the
Paley Foundation blog.
March 12, 2011
Dr. Paley and the Paley Foundation team returns to Haiti one year later on another humanitarian mission. Click Here to read the
Paley Foundation blog.
Dr. Paley honorary guest speaker in Ankara, Turkey (June 11-12, 2009) at the Hip Preservation Techniques in Adolescents
Course which will take place at the Crowne Plaza Hotel. This Conference is being Hosted by the Turkish Society of Orthopedics
and Traumatology. Dr. Paley will be speaking on 1) Surgical Dislocation for MHE 2) Extreme Acetabular Coverage with the Ganz
PAO and the PA-Triple Osteotomy 3) Femoral Head Intra-articular Osteotomy for the Treatment of Coxa Magna and Coxa Plana
Deformity 4) Superhip 1 procedure for Deformities of Congenital Femoral Deficiency (Paley type 1) 5) Superhip 2 procedure for
Pseudarthrosis of the Femoral Neck in CFD Paley Type 2 6) Ligamentum Teres Reconstruction of the Hip for Recalcitrant and
Teratologic Dislocation.
Course which will take place at the Crowne Plaza Hotel. This Conference is being Hosted by the Turkish Society of Orthopedics
and Traumatology. Dr. Paley will be speaking on 1) Surgical Dislocation for MHE 2) Extreme Acetabular Coverage with the Ganz
PAO and the PA-Triple Osteotomy 3) Femoral Head Intra-articular Osteotomy for the Treatment of Coxa Magna and Coxa Plana
Deformity 4) Superhip 1 procedure for Deformities of Congenital Femoral Deficiency (Paley type 1) 5) Superhip 2 procedure for
Pseudarthrosis of the Femoral Neck in CFD Paley Type 2 6) Ligamentum Teres Reconstruction of the Hip for Recalcitrant and
Teratologic Dislocation.
This website including the announcement page are updated continuously, please check back from time to time.
Last updated Nov 10, 2011
Website Mission
Last updated Nov 10, 2011
Website Mission
For many years, reliable surgical treatment of the rare bone disease (MHE) Multiple Hereditary Exostoses has been challenging.
The Paley Advanced Limb Lengthening Institute/St Mary's is pleased to announce their efforts to help correct this &
proud to be a sponsor of the Third International MHE Research Conference, to be held in Boston Oct 29-Nov 1, 2009. Dr.
Paley chaired the orthopedic session during this conference and present the latest surgical techniques in the correction of bones
deformities that occur in MHE patients. Dr. Paley is a long standing member of the Scientific and Medical Advisory Board of the
MHE Research Foundation, the organization organizing this conference.
The Paley Advanced Limb Lengthening Institute/St Mary's is pleased to announce their efforts to help correct this &
proud to be a sponsor of the Third International MHE Research Conference, to be held in Boston Oct 29-Nov 1, 2009. Dr.
Paley chaired the orthopedic session during this conference and present the latest surgical techniques in the correction of bones
deformities that occur in MHE patients. Dr. Paley is a long standing member of the Scientific and Medical Advisory Board of the
MHE Research Foundation, the organization organizing this conference.
Dr. Dror Paley and Dr. John Birch et al’s research paper was awarded best Clinical Paper Award at the 25th Annual Pediatric
Orthopedic Society of North America meeting in Boston (April 30-May 2, 2009).
This is a landmark article and is the first study to show that lengthening reconstruction surgery (using Dr. Paley’s
superankle procedure) achieves functional and psychologic results as good or better than amputation and
comparable to normal.
Title: Limb Reconstruction or Amputation for Severe Fibular Deficiency: A Two-Center Comparison of Psychosocial Adjustment,
Quality of Life, Patient Satisfaction, and Physical Function
Abstract:
What was the question? What are the functional abilities, psychosocial status, quality of life (QOL) characteristics,
patient/parent satisfaction, and medical intervention requirements for children with severe fibular deficiency who undergo either
amputation or limb reconstruction?
Orthopedic Society of North America meeting in Boston (April 30-May 2, 2009).
This is a landmark article and is the first study to show that lengthening reconstruction surgery (using Dr. Paley’s
superankle procedure) achieves functional and psychologic results as good or better than amputation and
comparable to normal.
Title: Limb Reconstruction or Amputation for Severe Fibular Deficiency: A Two-Center Comparison of Psychosocial Adjustment,
Quality of Life, Patient Satisfaction, and Physical Function
Abstract:
What was the question? What are the functional abilities, psychosocial status, quality of life (QOL) characteristics,
patient/parent satisfaction, and medical intervention requirements for children with severe fibular deficiency who undergo either
amputation or limb reconstruction?
Dr. Paley Presidential Guest Speaker at the Swedish Orthopedic Society August 25-27, 2009 and a visiting Professor at the
prestigious Karolinska Institute in Stockholm August 23-24. He will lecture there on topics related to limb lengthening and
deformity correction.
prestigious Karolinska Institute in Stockholm August 23-24. He will lecture there on topics related to limb lengthening and
deformity correction.
How did you answer the question? Twenty children who underwent amputation at one center were compared with 22
children who underwent limb reconstruction at a second center. Average evaluation age was 9 years (range, 5–15 years) and
included psychosocial, QOL, and satisfaction surveys and gait analysis with timed 25-yard dash. Number and nature of surgical
procedures were recorded.
What are the results? Families of children who underwent amputation had lower economic and educational levels and were
more ethnically diverse compared with the reconstruction group. Parents of males who underwent amputation perceived a lower
QOL for their child (p<0.05); socioeconomic and ethnic differences between the two groups might account for this finding. No
other statistically-significant differences between the two groups or between the groups and a healthy population were
observed in psychosocial and QOL surveys. All patients and parents reported satisfaction with treatment selected and would
select the same treatment again. While statistically significant differences in some parameters were identified between the
groups by gait analysis at self-selected walking speed, there were no significant differences in average performance or timed 25-
yard dash. Two of 20 patients with amputation also underwent three additional surgical procedures: two medial hemi-
epiphysiodeses for valgus and one anterior cruciate ligament reconstruction (average, 1.2 procedures per patient). Twenty-two
patients treated by reconstruction underwent an average 3.4 surgical procedures (range, 2–7), including 1.4 lengthenings
(range, 1–3). During the interval from amputation to survey, patients required an average 2.2 prosthetic repairs/adjustments
per year and 0.84 prostheses/year (private sector estimated average cost $8,863 per prosthesis). Mean surgical costs for
patients undergoing reconstruction were $24,800 (range, $15,000–$33,600) per reconstructive procedure and $3,300 (range,
$2,600–$4,600) for removal of lengthening devices.
children who underwent limb reconstruction at a second center. Average evaluation age was 9 years (range, 5–15 years) and
included psychosocial, QOL, and satisfaction surveys and gait analysis with timed 25-yard dash. Number and nature of surgical
procedures were recorded.
What are the results? Families of children who underwent amputation had lower economic and educational levels and were
more ethnically diverse compared with the reconstruction group. Parents of males who underwent amputation perceived a lower
QOL for their child (p<0.05); socioeconomic and ethnic differences between the two groups might account for this finding. No
other statistically-significant differences between the two groups or between the groups and a healthy population were
observed in psychosocial and QOL surveys. All patients and parents reported satisfaction with treatment selected and would
select the same treatment again. While statistically significant differences in some parameters were identified between the
groups by gait analysis at self-selected walking speed, there were no significant differences in average performance or timed 25-
yard dash. Two of 20 patients with amputation also underwent three additional surgical procedures: two medial hemi-
epiphysiodeses for valgus and one anterior cruciate ligament reconstruction (average, 1.2 procedures per patient). Twenty-two
patients treated by reconstruction underwent an average 3.4 surgical procedures (range, 2–7), including 1.4 lengthenings
(range, 1–3). During the interval from amputation to survey, patients required an average 2.2 prosthetic repairs/adjustments
per year and 0.84 prostheses/year (private sector estimated average cost $8,863 per prosthesis). Mean surgical costs for
patients undergoing reconstruction were $24,800 (range, $15,000–$33,600) per reconstructive procedure and $3,300 (range,
$2,600–$4,600) for removal of lengthening devices.
What are your conclusions? Function, psychosocial adjustment, and QOL after primary amputation or limb reconstruction in
skeletally immature patients with severe fibular deficiency are comparable and within normal limits for a healthy population at this
interim stage of development and treatment. Both groups will require further surgical procedures during the remainder of skeletal
maturation. Parents and surgeons must weigh life-long prosthetic requirements against significantly increased surgical
intervention for limb reconstruction in selecting a treatment strategy for severe fibular deficiency.
skeletally immature patients with severe fibular deficiency are comparable and within normal limits for a healthy population at this
interim stage of development and treatment. Both groups will require further surgical procedures during the remainder of skeletal
maturation. Parents and surgeons must weigh life-long prosthetic requirements against significantly increased surgical
intervention for limb reconstruction in selecting a treatment strategy for severe fibular deficiency.
Dr. Paley lecturing in Medellin, Colombia teaching a Deformity Course (In Spanish) with Dr. Leon Mora on Nov. 6-9, 2009.
Dr. Paley guest speaker at the Aregentine Association of Orthopedics and Traumatology and at the Argentine Pediatric
Orthopedic Society Nov 30-Dec 3, 2009, in Salta, Argentina.
Orthopedic Society Nov 30-Dec 3, 2009, in Salta, Argentina.
Dr. Paley is Keynote Speaker at the Comparative Orthopedic Day at the University of Missouri on April 23, 2010.
Dr. Paley visiting professor at the Rush Graduation Thesis Day in Chicago Illinois on June 25, 2010.
June 1, 2010
Dr. Paley was appointed as an adjunct Professor at the University of Toronto as well as part time faculty at the Hospital for
Sick Children as of June 1, 2010. He will teach and operate at the Hospital for Sick Children.
It has been 23 years since Dr. Paley left Canada and the Hospital for Sick Children. He is honored to be associated with this
world renowned University and Hospital again.
Dr. Paley was appointed as an adjunct Professor at the University of Toronto as well as part time faculty at the Hospital for
Sick Children as of June 1, 2010. He will teach and operate at the Hospital for Sick Children.
It has been 23 years since Dr. Paley left Canada and the Hospital for Sick Children. He is honored to be associated with this
world renowned University and Hospital again.
December 1-4, 2010
Dr. Paley is speaker and Instructional Course Lecturer at the International Pediatric Orthopedic Symposium (the premier annual
pediatric orthopedic course co sponsored by the American Academy of Orthopedic Surgeons and by the Pediatric Orthopedic
Society of North America.) This meeting is taught by the who’s-who of pediatric orthopedics. Dr. Paley is presenting five
lectures, four Instructional Course lectures and one workshop; all four physician assistants are attending.
Dr. Paley is speaker and Instructional Course Lecturer at the International Pediatric Orthopedic Symposium (the premier annual
pediatric orthopedic course co sponsored by the American Academy of Orthopedic Surgeons and by the Pediatric Orthopedic
Society of North America.) This meeting is taught by the who’s-who of pediatric orthopedics. Dr. Paley is presenting five
lectures, four Instructional Course lectures and one workshop; all four physician assistants are attending.
November 12, 2010
Dr. Paley is visiting professor at University of Mississippi, Jackson. Dr. Paley will be performing a pro bono surgery on a child
with Congenital Femoral Deficiency.
Dr. Paley is visiting professor at University of Mississippi, Jackson. Dr. Paley will be performing a pro bono surgery on a child
with Congenital Femoral Deficiency.
January 26-28, 2011
Dr. Paley presents during the combined meeting of British Limb Reconstruction Society & British Society for Children’s
Orthopaedic Surgery. Lecture notes from BLRS/BSCOS meeting
October 9-11, 2010
Invited Guest Speaker at the meeting of Fundacion ALPE Achondroplasia, Gijon, Asturias, Spain. Dr. Paley was speaking about
his methods for lengthening for Achondroplasia. Fundación ALPE ‘s mission is to aid persons with achondroplasia and their
families in different fields: medical, educational, psychological, employment, and social. In 2006 Fundación ALPE was awarded
with the Great Golden Cross of the Civil Order of Social Solidarity from the Ministry of Social Welfare of Spain. www.
fundacionalpe.org
October 13-15, 2010
Dr. Paley Bertha Neuberg visiting Professorship to the University of Göteborg, Sweden and Presidential Guest Speaker at the
Swedish Paediatric Orthopaedic Society.
October 19, 2010
Dr. Paley is Chairman, Principles of Deformity Correction Course, Barcelona, Spain. Physician Assistants Servando Gutierrez,
PA-C and Jennifer Pinsky, PA-C will be helping to instruct at this one day course.
October 20-22, 2010
Dr. Paley invited speaker and Instructional Course Lecturer at the ASAMI International and World Congress of External Fixation
meeting in Barcelona, Spain. Dr. Paley is giving six lectures including an instructional course lecture on Congenital Femoral
Deficiency.
October 27-29, 2010
Dr. Paley is Presidential Guest Lecturer at the XXX Annual meeting of the Portuguese Society of Orthopaedics and
Traumatology, Vilamoura/Algarve-Portugal. Dr. Paley will be giving a special lecture on the Advances in Perthes Disease in honor
of the 100th year anniversary of Perthes.
Dr. Paley presents during the combined meeting of British Limb Reconstruction Society & British Society for Children’s
Orthopaedic Surgery. Lecture notes from BLRS/BSCOS meeting
October 9-11, 2010
Invited Guest Speaker at the meeting of Fundacion ALPE Achondroplasia, Gijon, Asturias, Spain. Dr. Paley was speaking about
his methods for lengthening for Achondroplasia. Fundación ALPE ‘s mission is to aid persons with achondroplasia and their
families in different fields: medical, educational, psychological, employment, and social. In 2006 Fundación ALPE was awarded
with the Great Golden Cross of the Civil Order of Social Solidarity from the Ministry of Social Welfare of Spain. www.
fundacionalpe.org
October 13-15, 2010
Dr. Paley Bertha Neuberg visiting Professorship to the University of Göteborg, Sweden and Presidential Guest Speaker at the
Swedish Paediatric Orthopaedic Society.
October 19, 2010
Dr. Paley is Chairman, Principles of Deformity Correction Course, Barcelona, Spain. Physician Assistants Servando Gutierrez,
PA-C and Jennifer Pinsky, PA-C will be helping to instruct at this one day course.
October 20-22, 2010
Dr. Paley invited speaker and Instructional Course Lecturer at the ASAMI International and World Congress of External Fixation
meeting in Barcelona, Spain. Dr. Paley is giving six lectures including an instructional course lecture on Congenital Femoral
Deficiency.
October 27-29, 2010
Dr. Paley is Presidential Guest Lecturer at the XXX Annual meeting of the Portuguese Society of Orthopaedics and
Traumatology, Vilamoura/Algarve-Portugal. Dr. Paley will be giving a special lecture on the Advances in Perthes Disease in honor
of the 100th year anniversary of Perthes.
May 11, 2011
PALEY GROWTH by the Paley Institute
Introducing the iphone/ipad app for the Paley Prediction Multiplier Method!!!
Use this app to:
1. Predict Congenital and Developmental Limb length Discrepancy for upper or lower limbs
2. Calculate growth remaining from any upper or lower growth plate
3. Calculate timing of epiphysiodesis
4. Predict height in normals and achondroplasia
5. Calculate bone length, foot length, and sitting height at maturity
6. Predict fetal LLD to birth or maturity
Click this link for the FREE DOWN LOAD iphone/ipad app
For more information Click Here
Developed by Dr. Dror Paley and Eric Townsend
PALEY GROWTH by the Paley Institute
Introducing the iphone/ipad app for the Paley Prediction Multiplier Method!!!
Use this app to:
1. Predict Congenital and Developmental Limb length Discrepancy for upper or lower limbs
2. Calculate growth remaining from any upper or lower growth plate
3. Calculate timing of epiphysiodesis
4. Predict height in normals and achondroplasia
5. Calculate bone length, foot length, and sitting height at maturity
6. Predict fetal LLD to birth or maturity
Click this link for the FREE DOWN LOAD iphone/ipad app
For more information Click Here
Developed by Dr. Dror Paley and Eric Townsend
March 11, 2011
Dr. Paley presents during the American College of Foot and Ankle Surgeons (ACFAS) Annual Meeting held in Fort Lauderdale,
Florida, the topics were Challenging Rearfoot and Ankle Reconstruction, Salvage of the Mal-united Ankle Fracture and Surgical
Biomechanics, Supra Malleolar Biomechanical Considerations in Limb Deformity Surgical Biomechanics, Supra Malleolar
Biomechanical Considerations in Limb Deformity
Feb 17, 2011
Dr. Paley presents during the American Academy of Orthopaedic Surgeons Annual Meeting held San Diego, California the topic
was Limb Reconstruction or Amputation for Severe fiblar deicicency: A Two-Center Comparison
Feb 19, 2011
Dr. Paley presents during the Limb Lengthening and Reconstruction Society Specialty Day held at the end of the AAOS
conference the topics were Radial Aplasia and Wrist Deformities
Dr. Paley presents during the American College of Foot and Ankle Surgeons (ACFAS) Annual Meeting held in Fort Lauderdale,
Florida, the topics were Challenging Rearfoot and Ankle Reconstruction, Salvage of the Mal-united Ankle Fracture and Surgical
Biomechanics, Supra Malleolar Biomechanical Considerations in Limb Deformity Surgical Biomechanics, Supra Malleolar
Biomechanical Considerations in Limb Deformity
Feb 17, 2011
Dr. Paley presents during the American Academy of Orthopaedic Surgeons Annual Meeting held San Diego, California the topic
was Limb Reconstruction or Amputation for Severe fiblar deicicency: A Two-Center Comparison
Feb 19, 2011
Dr. Paley presents during the Limb Lengthening and Reconstruction Society Specialty Day held at the end of the AAOS
conference the topics were Radial Aplasia and Wrist Deformities
Paley Institute Limb Reconstruction Fellowship Program
This UNIQUE fellowship is designed for orthopedic surgeons
interested in developing an expertise in pediatric and adult limb
reconstruction surgery of the lower and upper extremities.
For more information Click Here
interested in developing an expertise in pediatric and adult limb
reconstruction surgery of the lower and upper extremities.
For more information Click Here
