Keeping kids in motion
A packed appointment schedule for John
Sarwark, MD, head of the Division of Orthopaedic Surgery, is nothing new. He
has time for everyone. The intense concentration he affords each patient,
parent, student, resident, fellow and staff member remains unbroken in the
constant stream of patients visiting for pre-operative consultations, fracture
check and progress assessments.
"Really, the work of a kid is playing," explains orthopaedic nurse Teresa
Philipp. "We want to give kids the best shot at walking, running, hopping and
skipping—essentially, doing the work of growing and developing—by keeping kids
in motion." According to the American Association of Orthopaedic Surgeons
(AAOS), musculoskeletal disorders sent 10 million U.S. children to the doctor in
1999 and are responsible for approximately 31,000 lost school days per year.
Regardless of the underlying diagnosis, the orthopaedic team at Children's
Memorial helps children improve their level of function and quality of life.
"Our job is often as much about building confidence and self-esteem as it is
about building stronger bodies, muscles and bones," says Sarwark who leads a
team that includes surgeons, medical residents, fellows, nurses, physical and
occupational therapists, rehabilitation specialists and orthotists.
But Sarwark and his colleagues have established an excellent record doing
just that — mending children's impaired muscles and bones. The division is
recognized among the best in the country for the diagnosis, treatment and
prevention of musculoskeletal disorders such as cerebral palsy, spina bifida,
complex limb and hip disorders, bone dysplasias and traumas.
Building a framework for excellence
Education and mentorship are constant elements in the hospital's busy
orthopaedics clinics. They occur everywhere between parents, patients,
physicians, nurses, medical residents, fellows and students. With seven
orthopaedic residents on rotation at one time, the division is able to handle
one of the largest outpatient volumes at Children's Memorial.
Sarwark recently completed a strategic plan to help fill the demand through a
comprehensive orthopaedics program. "We want to cover the water where pediatric
musculoskeletal disease is concerned," says Sarwark. The plan comes on the heels
of the United Nations' declaration of the 2000-2010 Decade of the Bone and
Joint, an international campaign to raise awareness and encourage research and
funding for musculoskeletal disorders.
With the expansion of Children's Memorial's premiere orthopaedic services to
more of Chicago's suburbs, the division of orthopaedic surgery is well prepared
for the attention that the decade will bring.
Also, a comprehensive sports
medicine program now combines expert evaluation and treatment of sports
injuries by a dedicated orthopaedic surgeon with a strong injury prevention
education component. The program aims to make physical activity and expression a
safe experience for children of all ages and abilities. "The sports medicine
program targets all children, including those with chronic conditions and
disabilities," says Sarwark, "not just the elite athletes."
Believing in the potential of research, Sarwark's plan includes a significant
clinical and basic science research component. "Through research we have an
opportunity to contribute to identifying inherited disorders that present to us
as orthopaedic problems," says Sarwark. Children's Memorial Research Center is home to some of the
most advanced immunobiological research in the world. Sarwark seeks to build
relationships with the developmental systems biology core as well as the child
health research core to document the long-term outcomes of care of Children's
Memorial's musculoskeletal patients.
"Our job," says Dr. Sarwark, "is often as much about
building confidence and self-esteem as it is about building stronger bodies,
muscles, and bones.
Prevention and advocacy
In addition to the traditional methods of diagnosis and treatment of
pediatric musculoskeletal disorders, Children's Memorial incorporates
non-invasive treatments, prevention education and advocacy into its orthopaedic
practice. It is a comprehensive approach that reflects the child-centered
mission of the hospital.
"We use surgery when it is the best or only option," says Sarwark. He and his
colleagues go to great lengths to avoid sending kids to the operating room
needlessly. They work closely with the orthotics and physical therapy
departments to find non-surgical solutions bush as bracing, casting and exercise
programs to correct muscle, bone and joint anomalies whenever possible, sparing
kids the risks and recovery time involved in undergoing a surgical procedure.
Because Children's Memorial orthopaedic surgeons see hundreds of patients
each year as the result of traumas from motor vehicle crashes, pedestrian,
bicycle, and in-line skating accidents, the hospital works closely with other
groups to help prevent such injuries. Sarwark champions child safety measures
such as using protective gear and proper child restraint equipment in cars.
Devotion in motion
Even in the busy world of orthopaedic surgery clinics, small victories are
celebrated as much as large ones. A spina bifida patient sitting up for the
first time after surgery receives as much applause as a former patient
performing the lead role in the Joffrey Ballet. To the staff and to families,
each of these accomplishments represents progress and success on its own terms.
It's all in a day's work for John Sarwark and the division of orthopaedic
surgery as they go about their business of keeping kids in motion.
Fast Facts
About Children's Memorial Hospital's Division of Orthopaedic Surgery
- State-of-the-art three-dimensional imaging equipment at the Motion Analysis Center directed
by Luciano Dias, MD, enables
physicians to detect and diagnose subtle locomotion problems that are not
apparent to the naked eye.
- Children's Memorial leads the Midwest in pediatric spine care, performing
approximately 120 spinal fusions annually.
- Children's Memorial has the largest specialized clinic in the Midwest for
two of the most common orthopaedic disorders: spina bifida and
scoliosis. Combining the expertise of pediatric orthopaedists and
neurosurgeons, the spina bifida clinic draws patients from around the world.
- The hand clinic, co-directed by orthopaedic surgeon Erik King, MD, and
plastic surgeon Frank Vicari, MD, is only one of two in the country
specializing in the evaluation and treatment of congenital and acquired hand
disorders in children.
[Note: This article has been adapted from the Fall 2001 issue of
Carousel, a magazine of Children's Memorial Hospital.]