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A clubfoot is where the foot is turned in on itself and points toward the ground. A clubfoot diagnosis during pregnancy is surprising and challenging during any circumstance. And in the case of parents anticipating surgery during a pandemic, options can be scarce. These parents took a deep breath, and with the help of Michael J. Elliott, MD, pediatric surgeon with Renown Children’s Hospital, their baby is on the road to recovery.

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

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For Michael J. Elliott, MD, a pediatric orthopedic surgeon specializing in scoliosis, it’s just another day helping patients. But to local five-year-old Makenna Christensen, her substantial spine correction is life-changing. Though her journey to body confidence was months in the making, her smiles are a reminder that a thorough, thoughtful treatment plan can yield amazing results. A Surprising Start Words don’t adequately describe the feelings you have when you unexpectedly learn your child has a birth defect. For Nicole and Nick Christensen it was a shocking surprise. During Nicole’s sonogram appointment something unusual was seen. After an amniocentesis, their baby girl was diagnosed with Noonan syndrome, which can affect a child’s height and bones. To prepare, the couple read all they could on the subject. Fortunately their daughter Makenna, was born full term and healthy. Shortly after birth, Makenna had some feeding issues and returned to the hospital. Although they resolved and she had no major complications, both parents felt unsure about their newborn’s future. With the help of Nevada Early Intervention Services , Makenna’s development was monitored until she was three years old. “Her posture has been an issue her whole life,” says Nicole. Nick also noticed when Makenna started walking her range of motion was poor. It was especially noticeable when she got dressed and raised her arms to put on clothing. Nicole observed Makenna was falling a lot in preschool. She asked Makenna’s pediatrician about physical therapy to support her coordination and muscle tone. Although physical therapy was helping Makenna, her therapist suggested Nicole seek the opinion of Dr. Michael Elliott, a pediatric specialist in orthopedics at Renown Children’s Hospital. Scoliosis Casting - A Successful Treatment Approach Dr. Elliott diagnosed Makenna with scoliosis, an abnormal curvature of the spine. While this condition is most common during a teenage growth spurt, it can also happen in early childhood. Affecting about four million people in the United States, it is estimated 20 percent of all spinal deformities in the U.S. are people living with scoliosis. Makenna’s spinal curve was significant – over 30 degrees. Through years of experience Dr. Elliott opted to put Makenna in a spinal cast, instead of multiple surgeries. “My approach is to postpone surgery as long as possible - it is tough for the patient and families,” he says. “Often excellent results can be achieved through non-invasive treatments such as, casting and bracing.” Nicole appreciated Dr. Elliott’s reassurance through the treatment plan. “It was obvious through the X-rays that there was a significant issue,” she shares. “He guided us through the timing and process and how correcting it sooner would help keep her future growth on track.” For seven months Makenna wore a cast that looked like a tank top, bracing her spine while allowing movement. Now she wears a hard plastic brace, specially fitted to her body.  “Kids tolerate casting well,” explains Dr. Elliott.  “It is a 45-minute procedure. The patient sleeps while their spine is put into traction as the cast dries.” She will continue to wear larger braces as she grows, eventually only wearing them at night. A Straight Path into the Future Dr. Elliott admits, “Not every cast is a cure. Two thirds of a child’s spinal growth happens by the age of five. Getting past the five-year mark means fewer surgeries. It’s wonderful to see Makenna’s body image improved.” Nicole agrees, “The way Makenna holds herself is completely different. She’s more confident on her feet and more balanced.” She can now play with her sister Aria, 4, and brother Lexi, 8 months, without the fear of falling. Nick is in awe of the improvements she has made, “Seeing her thrive more has been wonderful.” The Christensen’s are hopeful about the future. “Makenna is doing really good. She’s wearing her hard brace full time and her growth is consistent,” expresses Nicole. “She’s even starting swim lessons this week.” With mask wearing at every doctor visit during the COVID-19 pandemic, Makenna and Dr. Elliott look forward to seeing each other’s smiles in the future. Makenna’s story highlights the over 18 different specialty options for children locally at Renown Children’s Hospital.

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Every year, 170 Children's Miracle Network Hospitals (CMNH) across the country name a champion in each of their local communities who will serve as the face for children treated at their community’s children's hospital. Emmalee Sutton, 16, served as Renown Children’s Hospital Champion Child for the past two years, raising awareness for children’s healthcare in northern Nevada and across the nation. A Fighter from the Start Emmalee was diagnosed at age two with autoimmune hepatitis and Addison’s disease, which means her body underproduces critical hormones. It also means that, from an early age, Emmalee spent a lot of her time within the walls of Renown Children’s Hospital. She has endured a long road of illnesses and hospitalizations since, including her gallbladder being removed at age eight, port surgery at 13 and she has received several liver biopsies over the years. However, this disease does not define who Emmalee is; in fact it empowers her to be a fighter for herself and for other kids just like her who are battling disease and illness from a young age. Despite these challenges, Emmalee is a source of hope and inspiration to everyone she meets, never allowing her medical conditions to hold her back. Emmalee knows her story will inspire other young patients to continue fighting and believing in themselves. “Instead of complaining about all the things I can’t do, I celebrate all the things I can do,” Emmalee said. A Voice for Kids and Families Like Hers In her time as our Champion Child, and even well before the official title, Emmalee was a spokesperson for all the children in our community who need care. Since moving into the role of Champion Child in 2021, Emmalee has accomplished an impressive amount over the past two years. To name a few, here are some accomplishments Emmalee has achieved as Renown's Champion Child: Touring donors around Renown Children’s Hospital Promoting Renown’s Panda Cares Center for Hope Helping at Costco each year during their Miracle Balloon Campaign Making blizzards at Dairy Queen on Miracle Treat Day Standing on stage with The Beach Boys to share her experiences in the hospital and talk about the need for outstanding critical care close to home Attending Reno Health Foundation events announcing donations to Renown Children’s Hospital Working alongside NFL legend Steve Young, championing the importance of music therapy for kids staying in the hospital with the announcement of Sophie’s Place Being featured in a television show pilot with the National Automobile Museum In September 2021, Emmalee was awarded the Reno PBS Spotlight Award for Extraordinary Youth. She was highlighted as an individual who makes a positive impact on her community. For her efforts, Emmalee was honored with a $1,000 award, which she generously donated to Renown Children's Hospital. Emmalee’s commitment to Renown inspires us to continue Fighting the Good Fight for our youngest patients, so we can continue to provide the best care for kids like her. Dream it, Wish it, Do it While Emmalee’s tenure as Champion Child ends this month, her passion for helping members of our community is just getting started. Inspired by her drive to work with young girls, Emmalee is taking a counselor-in-training course with the Girl Scouts. She is excited to shape the future of these girls' lives by being a mentor and leader. She has been a Girl Scout for nine years and gives credit to the organization for making a positive impact on her life and contributing to many of the leadership qualities she possesses today. “The Girl Scouts has helped me understand that I am a strong, independent, compassionate young lady, and I use those thoughts whenever I am having all the health issues I have had to endure,” Emmalee said. What else is next for Emmalee? She hopes that being a Girl Scout and training to be a counselor will help her achieve her long-term goal of becoming a pediatric nurse. “I can’t thank the nurses and doctors at Renown enough for the love and care they have given me and continue to do so. They are my inspiration!” she said. But for us, Emmalee is the inspiration. From all of us at Renown, thank you, Emmalee. You motivate us to be our best. How You Can Help Make a Difference Renown Health is focused on being the destination for all your family’s health and healthcare needs. As a not-for-profit health system, Renown relies heavily on community funding. If you are interested in supporting Renown Children’s Hospital, and kids like Emmalee, please consider giving to Renown Health Foundation. Donations are accepted through the following ways: Make a gift at renown.org/give Call Renown Health Foundation at 775-982-5545 Mail a check to Renown Health Foundation, 1155 Mill St., 02, Reno, NV 89502

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