(From the November 2015 Issue of PediatricsOnline)
The Hand and Upper Extremity Program at Nationwide Children’s Hospital brings together departments of orthopaedic surgery and plastic and reconstructive surgery to provide comprehensive care to pediatric patients with upper extremity conditions. With the addition this fall of orthopaedic surgeon Julie Balch Samora, MD, PhD, the program will have an even greater focus on developing the knowledge and techniques to advance the field.
“Dr. Samora is leading our research, bringing an expertise to that area,” says James E. Popp, MD, director of the Hand and Upper Extremity Program at Nationwide Children’s. “Her focus on excellent patient outcomes, and the science to achieve those outcomes will help lead our program into the future.”
The Hand and Upper Extremity Program at Nationwide Children’s treats patients with complex congenital differences, including hypoplasia, polydactyly, syndactyly, overgrowth, amniotic band syndrome, radial longitudinal deficiencies, and central deficiencies. Other areas of expertise include hand and upper extremity trauma, microvascular reconstruction, sports injuries, and upper limb differences due to cerebral palsy and neuromuscular disease.
While she treats a wide variety of orthopaedic and hand conditions, Dr. Samora’s particular surgical interests are congenital hand differences and brachial plexus birth palsies. Nationwide Children’s Hospital brings a multidisciplinary, comprehensive approach to brachial plexus birth injuries. When hand and upper extremity function is affected by these injuries during the birth process, nerve transfers, nerve grafting, tendon transfers, or even bony procedures may be necessary.
“It’s wonderful that we have orthopaedic surgeons, plastic surgeons and neurosurgeons collaborating on brachial plexus injuries. It’s rare to see that type of collaboration in other places,” Dr. Samora explains. “It’s not only exciting, but quite beneficial and in the best interest of patient care to share perspectives from all of these specialists. It’s a meeting of the minds on how to manage these sometimes devastating injuries, because no two plexus cases are the same.”
Dr. Popp agrees that the ability to collaborate across specialties is one of the strengths of the treatment of upper extremity conditions at Nationwide Children’s, and the collaboration will only deepen with Dr. Samora’s involvement.
“Sometimes the plastic surgeon’s approach can be radically different from the orthopaedic approach,” he says. “Orthopaedic surgeons are trained to focus on the musculoskeletal aspects like bone, muscles, tendons and joints, while plastic surgeon training emphasizes the soft tissue aspects of the human body. Together, we approach the child from two varying perspectives striving for the best care of each patient.”
Dr. Samora is confident that these partnerships as well as growth in research, education and quality improvement efforts will enable Nationwide Children’s Hospital to provide the greatest level of patient care regionally, and help guide treatment in other centers nationally.