New staff and new diagnostic equipment have substantially increased our ability to diagnose and treat the most complex pediatric eye conditions at The Children’s Hospital. The opening of the Rocky Mountain Lions Eye Institute on the Fitzsimons campus of the University of Colorado has expanded opportunities for treating the pediatric ophthalmology patient. Participation in the Pan American Association of Ophthalmology and Dr. Bateman’s pending presidency of the Association have extended the influence of The Children’s Hospital within the international community.

Clinical Activities
Serving as an anchor clinic for the Aurora, Broomfield and Littleton Specialty Care Centers, the orthopaedic staff expanded clinic hours at these locations to meet a growing need for orthopaedic outpatient services. Regional clinics were also held in Alamosa, Colorado Springs, Grand Junction, Pueblo, Sterling and Vail. In 2002, the department tallied 19,736 outpatient visits at the main hospital and through the network of care provided by the satellite clinics. The orthopaedic surgeons also performed more than 3,300 operating room cases in 2001/2002.

Several new pathways have been developed including pathways for clubfoot, high-risk spine fusion, idiopathic spine fusion and femoral osteotomies for hip subluxation/dislocation.

Mark Erickson, MD, serves as Medical Director of the Spine Center. Elise Benefield, RN, coordinates the Center. The Center was initiated in 1998 to treat kids with idiopathic spine problems and also high-risk kids with underlying health problems such as cerebral palsy and spina bifida. A half-day orientation session for young patients and their parents educates families about what to expect fromspine surgery and how to improve recovery time. The preoperative involvement of the pain service, OR nurse, respiratory therapist and physical therapist and former patients and their parents has lessened the stress around complex spine surgeries.

The Children’s Hospital Spine Center sees kids with the most complex spine conditions. About 20% of the center’s cases are high-risk kids. In 2000, a special pathway for high-risk kids was developed. By the end of 2002, length of hospital stay for these high-risk kids decreased 40% from just over 20 days to just over 12. Time in intensive care was also substantially reduced. The involvement of the hospital’s ethics committee also helps parents deal with questions around the risks of surgery for medically fragile children. The Spine Center’s program serves as a model for other pediatric hospitals, several of which have contacted the service for advice on treating high-risk spine surgery patients.

The Center for Gait and Movement Analysis at The Children’s Hospital studies walking patterns, including the use of braces and other adaptive equipment to determine the best therapies for kids with such diagnoses as cerebral palsy, spina bifida, muscular dystrophy and congenital abnormalities. Sophisticated computer analysis lets doctors and kinesiologists clearly see the cause of movement disorders and recommend surgical intervention, physical therapy, medication or the most efficacious combination of the three. In addition to the analysis and treatment available through the center, care is enhanced through the Disabled Sports Program. Skiing trips to nearby resorts help kids with movement problems build physical strength and mental toughness. Many patients have gone on to participate in the Special Olympics and the Olympics, accomplishing an extraordinary level of athleticism despite serious health challenges.

In 2002, Brooke Pengel, MD, was hired to meet an increasing demand for sports medicine expertise. Dr. Pengel works out of both the main hospital campus and the new Broomfield Specialty Care Center that is anchored by the Orthopaedic department.

Commitment to Teaching
Internally, three weekly education/research conferences are held to discuss current research projects, case presentations and pre-operative issues.

In addition to offering established orthopaedic fellowships, the department is involved in some creative partnerships to offer supplemental training opportunities. International “observational” fellowships have been extended to doctors from China, Brazil, Thailand and India. In collaboration with the U.S. Army, a fellowship is offered through the Brooke Army Medical Center in Texas.

Each spring, the department sponsors Orthopaedic Children’s Day, a regional educational workshop for orthopaedic surgeons, fellows, residents, pediatricians, physician assistants, nurses, physical therapists and technologists. The one- day workshop presents the latest in pediatric protocols and research.