Dr. Panagiotis Glavas, a professor of Surgery at the University of Montreal, recently performed an unprecedented technique in pediatric orthopedic surgery which will allow a young patient at Sainte-Justine Hospital to walk once more.
Through a series of complex procedures unprecedented in pediatric orthopedic surgery, Dr. Glavas has made history in restoring full ambulatory capability to “Charlie,” a child with a severe disability.
Charlie was forced to have both his legs amputated at the mid-tibia level in January of 2015 after he had been stricken with a flesh-eating disease at only eighteen months of age.
While the amputation saved the child’s life, the bacteria had still had enough time to infect other cells, particularly those which govern bone growth.
The bones of the amputated legs began to grow again, but outward, rather than downward, at an abnormal angle which made fitting a prothesis difficult and painful.
Charlie, who was increasingly confined to his wheelchair, had essentially given up any hope of one day walking again.
“There was a three-dimensional deformation at the end of what was left of his leg and we could not reconstruct and realign using traditional methods,” Dr. Glavas explained. “So we decided to call in all the technology we now have access to.”
The surgeons used a 3D printer to create a cutting guide — an implant fixed directly on the tibia during surgery — to precisely reproduce the correction to the bone, which was determined during a pre-op simulation.
The surgical team also used the printer to create a titanium plate to connect two sections of Charlie’s left tibia, since no prefabricated plate could be fitted to Charlie’s particular bone growth.
Given the success of this surgery, Charlie’s right leg will also undergo the same procedure soon. The groundbreaking new technique offers new possibilities for a range of other surgeries, particularly those involving young patients.
“I’m starting to use it a little more now, given that we have such precision, to correct angular deformations,” said Glavas. “I think it will become more and more common to produce made-to-measure implants, particularly in pediatrics, since children come in all sizes.”
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