| I WROTE THE BOOK ON DEFORMITY CORRECTION |
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 will chair 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.
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 will chair 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?
ANNOUNCEMENTS
Dr. Paley is an 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.
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.
Dr. Paley will be the 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.
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.
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.
This website including the announcement page are updated continuously, please check back from time to time.
Last updated May 31, 2009
Website Mission
Last updated May 31, 2009
Website Mission
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 will be lecturing in Medellin, Colombia teaching a Deformity Course (In Spanish) with Dr. Leon Mora on Nov. 6-9, 2009.
Dr. Paley will be lecturing in Medellin, Colombia teaching a Deformity Course (In Spanish) with Dr. Leon Mora on Nov. 6-9, 2009.
Dr. Paley will be a 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.
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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 |
Dr. Paley will be the Keynote Speaker at the Comparative Orthopedic Day at the University of Missouri on April 23, 2010.
Dr. Paley will be a visiting professor at the Rush Graduation Thesis Day in Chicago Illinois on June 25, 2010.