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CHKD collaborates with Operation Smile
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CHKD surgical services directory
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Multidisciplinary approach offers successful management of adolescent idiopathic scoliosis By H. Sheldon St. Clair, MD, and John K. Birknes, MD
Summary: At CHKD, pediatric orthopedic surgeons and neurosurgeons collaborate to achieve best outcomes for children and young adults with adolescent idiopathic scoliosis.
ACL repair in young female athletes
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. It affects females 10 times more often than males and typically presents during the pre-adolescent growth spurt – at around age 10 for girls and age 14 for boys.
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CHKD welcomes new surgeons CHKD Surgical Group Journal is a publication of Children’s Hospital of The King’s Daughters Health System
H. Sheldon St. Clair, MD
Medical Editors: Joseph F. Dilustro, MD, FACS Robert E. Kelly Jr., MD, FACS, FAAP Jyoti Upadhyay, MD, FAAP Douglas Mitchell, MD, FAAP
Managing Editor Ridgely Ingersoll Director of Marketing
Editor Sharon Cindrich Marketing & PR Manager
Graphic Designers Liz Lane Eric Cardenas
John K. Birknes, MD
The classic evaluation for scoliosis is the Adams forward bend test. When a child with scoliosis bends forward, an asymmetrical elevation of the ribs may be present on one side. Asymmetrical alignment of the shoulder or hip, scapular prominence, or trunk shift may also be present. Other less obvious symptoms of AIS may include lesions along the back and pelvic obliquity. Pediatricians should also look for limb length discrepancies if AIS is suspected. (To see a brief video demonstration of a scoliosis screening with Dr. John Birknes, visit CHKD.org/Scoliosis.) To best address the complex interdependency between the nerves of the spinal cord and the vertebrae of the spinal column, Children’s Hospital of The King’s Daughters offers a team approach to scoliosis treatment and spinal surgery. In addition to pediatric orthopedic surgeons and neurosurgeons, the team includes pediatric specialists in physical medicine and rehabilitation, anesthesiology and physical therapy, plus pulmonology and cardiology when appropriate. The team performs approximately 225 spinal surgeries a year on patients under the age of 21; two-thirds of these are for scoliosis. Treatment plans are developed at weekly team conferences and are based on the location, shape and severity of curve, the number of curves and whether there is rotation of the spine, which occurs in many cases. Early diagnosis of scoliosis can allow treatment that prevents further progression of curves while the spine continues to grow. When scoliosis is suspected in pre-adolescents, an MRI may be indicated to rule out any alternative causes of a spinal deformity, such as a neurological lesion. In cases of moderate severity, bracing is the most common first treatment for scoliosis. Bracing rarely corrects curves, but it can keep them from progressing and therefore prevent the need for surgery when they get older. CHKD surgeons
Pre-operative X-ray (left) of a female patient age 17 with 58 degree upper spinal curvature and a 40 degree lower spinal curvature. Post-operative Xray(right) shows correction using the Ponte osteotomy which employed two cobalt alloy rods and 18 screws.
employ several types of braces and both full-time and night-only systems. The location of the curve and skeletal maturity of the patient help determine the most effective bracing program. Physical therapy prior to surgery can improve body mechanics and help with the mechanical pain often associated with scoliosis. While exercise programs have not been shown to affect the progression of scoliosis, they remain a part of the overall program in the treatment of scoliosis. CHKD physical therapists have specialized training in exercises designed to help patients with idiopathic scoliosis prior to surgery. Patients with thoracic curves greater than 50 degrees and thoracolumbar curves greater than 40 degrees are candidates for surgical correction. Untreated deformities often continue to progress throughout life and can result in significant cosmetic deformity as well as pain or even cardiopulmonary compromise. Modern scoliosis surgery is a far cry from the procedures of earlier decades that involved several months of bed rest in a body cast. Contoured and segmented instruments are more stable and have improved surgeons’ ability to correct curves and rotations. CHKD’s surgeons use titanium and cobalt chrome implants during surgery to correct the deformity; bone fusion over the levels of the implant provides permanent correction.
Felix Tsai, MD
CHKD Surgical Group | Journal | Vol. 4, 2015
Typical recovery time for idiopathic scoliosis surgical corrections includes a five-day hospitalization, physical therapy, one month with limited activity before return to school and six months of protection from vigorous stress to the spine. Included among CHKD’s spine surgeon specialists are Drs. H. Sheldon St. Clair, John Birknes, Marc Cardelia, Carl St. Remy, Allison Crepeau, Allison Tenfelde and Jeremy Saller. CHKD’s scoliosis program is designed to provide personalized treatment plans and correction for all levels of AIS using the most current techniques. The CHKD team works closely with families toward desired outcomes to remove physical discomfort, to improve symmetrical physical appearance and emotional well-being and to prevent future physical complications. Long-term outcomes are best when AIS is treated through early referral and intervention. Dr. Birknes is board certified in neurological surgery and fellowship trained in pediatric spinal deformities. You may reach him at (757) 668-7990. Dr. St. Clair is board certified in orthopedic surgery, you may reach him at (757) 668-6550.
The R. Bryan Grinnan, M.D. Memorial Research Award was presented to CHKD cardiac surgeon Felix Tsai by the American Heart Association on March 8, 2014. In addition to providing surgical treatment of congenital heart disease, Dr. Tsai has implemented blood conservation measures to improve pediatric cardiac surgery outcomes and has helped standardize operative checklists and postoperative handoffs at CHKD to improve overall patient safety. To reach Dr. Tsai, please call 668-8850.
CHKD surgeon awarded R. Bryan Grinnan, M.D. Memorial Research Award
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CHKD has also recently adopted the Ponte osteotomy procedure in which facet joints and interspinous ligaments are removed to tilt the bones posteriorly through a mobile disc space, which allows the surgeon to return the spine to normal degrees of kyphosis.
CHKD collaborates with Operation Smile on patient with rare maxillary tumor By Jesus “Jegit” Inciong, MD
Summary: CHKD’s craniofacial reconstruction team create a new future for young patient from Haiti. Last spring, surgeons from CHKD and Operation Smile, the renowned Norfolk-based charity, collaborated to excise a massive tumor positioned inside the maxillary sinus of a 15-year-old girl. The growth on the patient’s left maxilla was first resected Jesus “Jegit” Inciong, MD in 2011 in a Haitian hospital near the girl’s home, but recurrence and rapid growth followed. The mass eventually displaced the patient’s left eye and orbit, causing exposure keratitis and blindness. It also displaced her nose and lower jaw, causing an open bite and difficulty in chewing and swallowing. Physicians suspected the mass to be an ameloblastoma, fibrous dysplasia or desmoid tumor. CT scans and MRI studies showed the large maxillary mass displacing the orbit, nasal bones, contralateral maxilla and the mandible. It extended to the base of the cranium but did not penetrate it. Operation Smile accepted the patient as a World Care patient for surgery in the United States and reached out to CHKD, its longstanding partner in charitable pediatric craniofacial reconstruction for international patients. With support from a private donor, the patient was transferred to Norfolk to receive the complicated and multi-disciplinary removal and reconstruction. On April 28, 2014, a surgical team assembled at CHKD for a left maxillectomy and tumor excision. In addition
to Dr. William Magee, Operation Smile co-founder and head plastic surgeon for the procedure, the surgical team included Drs. Jegit Inciong and George Hoerr, CHKD plastic and craniofacial surgeons; Dr. Joseph Dilustro, CHKD pediatric neurosurgeon; and Dr. Eric Crouch, a pediatric ophthalmologist. After removal of the tumor, surgeons used Medpor orbital and maxillary implants and coverage with a temporalis muscle flap and multiple mucosal and skin flaps to reconstruct the upper jaw. A mandibular osteotomy was also done to correct the positioning of the distorted mandible.
Before surgery.
A secondary procedure was performed in July to reconstruct and reposition the left lower eyelid and the upper and lower lips. The surgery included the use of multiple skin and mucosal flaps and grafts to reshape the left side of the face. A genioplasty was done to correct chin symmetry, and surgery was performed on the left eye to preserve the globe. The patient was fitted for an eye prosthesis and dentures. Final pathology showed the tumor to be a central ossifying fibroma of the maxilla. The patient remained on a medical visa until September for follow-up care by CHKD’s craniofacial surgeons before returning to Haiti. She is now home and back in school enjoying life as a normal teenager. CHKD’s multidisciplinary craniofacial team performed approximately 150 procedures in 2014. The team is accredited by the American Cleft Palate-Craniofacial Association (ACPA).
After surgery.
Dr. Inciong is a board-certified plastic surgeon at CHKD. You may reach him at (757) 668-7713.
Preoperative CT scans show significant impact of the central ossifying fibroma on patient’s orbit, nasal bones, contralateral maxilla and mandible. CHKD Surgical Group | Journal | Vol. 4, 2015
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CHKD Surgical Group For physician-to-physician consults and access: Call CHKD Doctors Direct, (757) 668-9999 or 1-800-207-2022 For a complete list of pediatric specialists and surgeons, visit chkd.org/referraldirectory
Cardiac Surgery Located at CHKD Surgeries offered at CHKD in Norfolk Consults......................................................... (757) 668-8850 Fax................................................................ (757) 668-9344
Felix Tsai, MD MD Degree: Northwestern University Residency: General Surgery, Morristown Memorial Hospital; Cardiothoracic Surgery, George Washington University Fellowship: Pediatric Cardiothoracic Surgery, Medical University of South Carolina Certification: American Board of Thoracic Surgery Special Interests: Neonatal heart surgery; mechanical circulatory support; quality improvement; enhanced patient safety E-mail Address: felix.tsai@chkd.org
Neurosurgery
Gary Tye, MD MD Degree: Medical College of Virginia Residency: Neurological Surgery, Medical College of Virginia Fellowship: Cincinnati Children’s Hospital Certification: American Board of Neurological Surgery Special Interests: Pediatric neurosurgery; tethered cord; epilepsy; brain tumors; endoscopic surgery; minimally invasive surgery E-mail Address: gary.tye@chkd.org
Orthopedics & Sports Medicine Located in Norfolk, Chesapeake, Virginia Beach and Newport News Surgeries offered at CHKD Surgery Centers in Norfolk, Newport News and Virginia Beach Appointments & consults................................ (757) 668-6550 Same-day appointments............................... (757) 668-6545 Fax................................................................ (757) 668-6544
J. Marc Cardelia, MD
Surgeries offered at CHKD in Norfolk Appointments & consults................................ (757) 668-7990 Fax................................................................ (757) 668-7995
MD Degree: Thomas Jefferson University Medical College, Philadelphia Residency: Surgery, UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ
John Birknes, MD
Fellowship: Pediatric Orthopedics, Rady Children’s Hospital, San Diego
Located at CHKD
MD Degree: Jefferson Medical College, Philadelphia
Certification: American Board of Orthopedic Surgery
Residency: Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia
Special Interests: Sports injuries; spinal deformity; trauma in children
Fellowship: Pediatric Neurosurgery, Children’s Hospital of Philadelphia; Pediatric Spinal Deformity and Scoliosis, Shriners Hospital for Children of Philadelphia
Allison Crepeau, MD
E-mail Address: marc.cardelia@chkd.org
Jeremy Saller, MD MD Degree: Medical School Texas Tech Health Science Center Residency: Medical School Texas Tech Health Science Center in Lubbock, Texas Fellowship: Alfred I. duPont Hospital for Children Certification: American Board of Orthopedic Surgery Special Interests: Clinical interest in neuromuscular disorders, limb deformity correction and spinal deformity surgery E-mail Address: jeremy.saller@chkd.org
H. Sheldon St. Clair, MD MD Degree: Medical College of Virginia Residency: Orthopedics, Tufts- New England Medical Center Hospital, Boston Fellowship: Pediatric Orthopedics, Boston Floating Hospital for Children Certification: American Board of Orthopedic Surgery Special Interests: Scoliosis and spinal deformities; cerebral palsy; neuromuscular diseases; limb lengthening and deformity correction; congenital deformities; sports injuries E-mail Address: harvey.st.clair@chkd.org
Carl R. St. Remy, MD MD Degree: Columbia University College of Physicians and Surgeons, New York Residency: Orthopedics, New York Orthopaedic Hospital, Columbia UniversityPresbyterian Hospital, New York Fellowship: Pediatric Orthopedics, Texas Scottish Rite Hospital for Children, Dallas Certification: American Board of Orthopedic Surgery Special Interests: Scoliosis and spinal deformities; neuromuscular disorders; limb reconstruction; congenital deformities; sports injuries; trauma
Certification: American Board of Neurological Surgery
MD Degree: Georgetown University School of Medicine
Special Interests: Brain tumors; spinal deformity and scoliosis; Chiari malformation; hydrocephalus; epilepsy; spina bifida/cerebral palsy; neuro-endoscopy
Residency: Orthopedics, SUNY at Stony Brook
E-mail Address: carl.st.remy@chkd.org
Fellowship: Pediatric Orthopedic Surgery, Arnold Palmer Hospital for Children; Pediatric and Adult Sports Medicine, Boston Children’s Hospital
MD Degree: Michigan State University College of Human Medicine
E-mail Address: john.birknes@chkd.org
Joseph Dilustro, MD, FACS MD Degree: Eastern Virginia Medical School Residency: Neurological Surgery, Eastern Virginia Medical School Graduate School of Medicine Fellowship: Microvascular and Cerebrovascular Surgery, London Health Sciences Center, University of Western Ontario Certification: American Board of Neurological Surgery Special Interests: Craniofacial surgery; brain tumors; spina bifida/cerebral palsy; hydrocephalus; cerebrovascular disorders in children; Chiari malformation E-mail Address: joseph.dilustro@chkd.org
Special Interests: Sports medicine; dance medicine; hip arthroscopy for treatment of labral tears and impingement E-mail Address: allison.crepeau@chkd.org
Cara Novick, MD MD Degree: New York University School of Medicine Residency: Orthopedics, New York University Medical Center/Hospital for Joint Diseases Fellowship: Pediatric Orthopedic Surgery, Shriner’s Hospital for Children Special Interests: Office-based pediatric orthopedics, fracture management, sports medicine Certification: American Board of Orthopedic Surgery E-mail Address: cara.novick@chkd.org
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CHKD Surgical Group | Journal | Vol. 4, 2015
Allison Tenfelde, MD Residency: Orthopedics, Michigan State University Fellowship: Pediatric Orthopedics, University of Michigan – Mott Children’s Hospital; Orthopedic Sports Medicine, Detroit Medical Center Certification: American Board of Orthopedic Surgery Special Interests: Pediatric and adolescent sports injuries; arthroscopic surgery of the shoulder, knee and elbow E-mail Address: allison.tenfelde@chkd.org
Pediatric Surgery Located at CHKD, Virginia Beach, Chesapeake and Newport News
Surgeries offered at CHKD Surgery Centers in Norfolk, Newport News and Virginia Beach Appointments & consults........................... (757) 668-7703 Fax........................................................... (757) 668-8860
Frazier Frantz, MD, FACS MD Degree: Duke University School of Medicine Residency: General Surgery, Medical College of Virginia Fellowship: Pediatric Surgery, Children’s Hospital Medical Center, Cincinnati Certification: American Board of Surgery, Pediatric Surgery Special Interests: Surgical treatment of colorectal diseases in children; congenital chest wall deformities; vascular anomalies
M. Ann Kuhn, MD, FACS, FAAP
MD Degree: Marshall University, John C. Edwards School of Medicine Residency: General Surgery, Ohio State University Fellowship: Pediatric Surgery, University of Oklahoma Health Sciences Center Certification: American Board of Surgery, Pediatric Surgery Special Interests: Minimally invasive laparoscopic surgery; Nuss procedure for pectus excavatum repair and other chest deformities; colorectal disease; thoracic surgery; surgical oncology E-mail Address: ann.kuhn@chkd.org
Michele Lombardo, MD
MD Degree: Boston University School of Medicine Residency: General Surgery, Brown University and Rhode Island Hospital
E-mail Address: frazier.frantz@chkd.org
Fellowship: Pediatric Surgery, Brown University and Hasbro Children’s
Michael Goretsky, MD, FACS, FAAP
Certification: American Board of Surgery
MD Degree: State University of New York, Stony Brook Residency: General Surgery, University of Cincinnati; Pediatric Surgery, Children’s Hospital of Michigan, Detroit Fellowship: Surgical Research, Shriners Burn Institute, Cincinnati; ECMO, Children’s Hospital of Cincinnati
Jesus “Jegit” Inciong, MD, FACS, FAAP MD Degree: University of the Philippines Residency: Plastic Surgery, University of the Philippines Fellowship: Plastic Surgery, University of Southern California, University of Miami; Microsurgery and Craniofacial Surgery, Eastern Virginia Medical School Certification: American Board of Plastic Surgery Special Interests: Craniofacial Surgery, Cleft Lip and Palate Surgery, Microsurgery, Birthmarks and Vascular Anomalies, Breast Reduction and Reconstruction, Congenital Hand Anomalies E-mail Address: jesus.inciong@chkd.org
Urology Located at CHKD, Chesapeake, Virginia Beach, Newport News and Williamsburg
Surgeries offered at CHKD Surgery Centers in Norfolk, Newport News and Virginia Beach Appointments & consults........................... (757) 668-7878 Fax........................................................... (757) 668-7883
Special Interests: Minimally invasive surgery; thoracic surgery; surgical oncology; ovarian tumors E-mail Address: michele.lombardo@chkd.org
Charles Horton Jr., MD, FAAP, FACS
Robert J. Obermeyer, MD, FACS, FAAP
Residency: General Surgery, Dartmouth University; Urology, Harvard University
MD Degree: University of Cincinnati College of Medicine
MD Degree: Eastern Virginia Medical School
Certification: American Board of Urology
Residency: General Surgery, Western Reserve Care Forum Health
Special Interests: Urogenital reconstruction; hypospadias; laparoscopy
Special Interests: Minimally invasive surgery; Hirschsprung’s disease; non-cardiac thoracic surgery; Nuss procedure for pectus excavatum repair and other chest deformities
Fellowship: Pediatric Surgery, University of Arkansas Children’s Hospital; Minimally Invasive Surgery, Baylor College of Medicine
E-mail Address: charles.horton@chkd.org
E-mail Address: michael.goretsky@chkd.org
Robert E. Kelly Jr., MD, FACS, FAAP
Special Interests: Minimally invasive laparoscopic surgery; pediatric thoracic surgery; pediatric surgical oncology; Nuss procedure for pectus excavatum repair and other chest wall deformities
MD Degree: Johns Hopkins University
E-mail Address: robert.obermeyer@chkd.org
Certification: American Board of Surgery, Pediatric Surgery
Residency: Surgery, Vanderbilt University, Nashville Fellowship: ECMO and Surgical Research, UCLA School of Medicine, Los Angeles; Pediatric Surgery, Children’s Hospital of Buffalo Certification: American Board of Surgery, Pediatric Surgery Special Interests: Esophageal and pulmonary problems; neck masses; Hirschsprung’s disease; Nuss procedure for pectus excavatum repair and other chest deformities; pectus carinatum E-mail Address: robert.kelly@chkd.org
Certification: American Board of Surgery, Pediatric Surgery
Plastic Surgery Located at CHKD, Chesapeake, Virginia Beach and Newport News
Surgeries offered at CHKD Surgery Centers in Norfolk, Newport News and Virginia Beach Appointments & consults........................... (757) 668-7713 Fax........................................................... (757) 668-7711
George Hoerr, MD MD Degree: University of Missouri, Columbia
Jyoti Upadhyay, MD, FAAP MD Degree: Wayne State University, Michigan Residency: General Surgery, Wayne State University; Urology, Wayne State University Fellowship: Pediatric Urology, Hospital for Sick Children, Toronto Certification: American Board of Urology Special Interests: Complex genitourinary reconstruction, including augmentation cystoplasty and catheterizable urinary stomas for neurogenic bowel and bladder disease; reconstructive surgery for ambiguous genitalia, congenital adrenal hyperplasia and intersex states; microscopic varicocelectomy; minimally invasive laparoscopic kidney procedures; ureteroscopy; holmium laser use for pediatric kidney and ureteral stones; certified to perform daVinci robotic-assisted pyeloplasties for ureteral anomalies E-mail Address: jyoti.upadhyay@chkd.org
Residency: General Surgery, EVMS/ Sentara Norfolk General/CHKD; Plastic Surgery, University of California – Irvine
Louis Wojcik, MD
Fellowship: Pediatric Plastic Surgery, USC/Children’s Hospital of Los Angeles
Residency: Brown University
Certification: American Board of Plastic Surgery Special Interests: Craniofacial surgery; congenital ear reconstruction; cleft lip and cleft palate; birthmarks and hemangiomas; congenital hand surgery E-mail Address: george.hoerr@chkd.org
MD Degree: Vanderbilt University School of Medicine Fellowship: Children’s Hospital San Diego Certification: American Board of Urology Special Interests: Hydronephrosis; hypospadias; undescended testis; vesicoureteral reflux E-mail Address: louis.wojcik@chkd.org CHKD Surgical Group | Journal | Vol. 4, 2015
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ACL Injury in Young Female Athletes – Prevention and Repair By Allison Tenfelde, MD CHKD Orthopedics and Sports Medicine
Summary: CHKD sports medicine program provides comprehensive techniques to prevent and correct ACL tears in female athletes. Increasing numbers of young female athletes are tearing their anterior cruciate ligament, or ACL. CHKD offers a proactive approach to preventing ACL injuries in adolescent girls, as well as advanced surgical techniques to repair ACL tears Allison Tenfelde, MD in young athletes. These techniques provide long term stability to the knee and developing growth plates and prevent future complications such as leg-length discrepancies and angular deformities. According to the American Academy of Orthopaedic Surgeons, female athletes who participate in jumping and pivoting sports are two to 10 times more likely to sustain a knee ligament injury than male athletes participating in the same sports. The risk is particularly high in athletes participating in soccer, basketball, volleyball and gymnastics. Anatomy, muscle mass and training put female athletes at an increased risk, especially after puberty. The ACL is especially vulnerable at certain times during a teen girl’s menstrual cycle. Research has shown that with proper training, the incidence of ACL injuries in female athletes can be lowered by as much as 80 percent. The CHKD sports medicine program has developed an ACL injury prevention program called CHKD Strong Girls to train female athletes as a first line of defense against ACL tears. Pediatric sports medicine physical therapists, exercise therapists and certified athletic trainers work with athletes to improve performance and prevent injury through strengthening techniques, core stabilization exercises, plyometrics, stretching, balance and coordination training. The six-week CHKD Strong Girls program meets two times a week to focus on proper jumping, landing and cutting techniques. Coaches and trainers can also arrange for a personalized CHKD ACL injury-prevention program for their entire team. The risk of ACL injury increases for female athletes by the age of 12 and for male athletes by the age of 14. When an athlete incurs a sudden or severe ACL tear, a loud popping sound is generally heard in the knee and the patient presents with pain, swelling and instability of the knee joint. Diagnosis can be
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CHKD Surgical Group | Journal | Vol. 4, 2015
determined through a physical examination of the joint and confirmed with an MRI. When an ACL tear is sustained by a young athlete, surgery is often required to prevent clinically significant knee instability and additional injuries in the future. Studies have also shown that surgical corrections of ACL tears in young athletes improve the likelihood that they will return to their previous level of activity. CHKD pediatric orthopedic surgeons repair ACL tears surgically in pre-adolescent patients using an advanced technique called physeal-sparing. Physeal-sparing is a minimallyinvasive procedure done arthroscopically through small incisions surrounding the knee. A ligament graft is used to re-create the ACL. Then tunnels are established through the femur and tibia to thread and secure the tendon graft, using fluoroscopy to ensure that the physis is avoided. This procedure eliminates the risk of growth plate disturbance associated with traditional repair techniques and leaves the patient with a very low likelihood of requiring additional surgery when the bones stop growing. Last year, CHKD surgeons performed 63 ACL surgeries. Generalized complications are extremely rare but can include infection, re-tear, loss of motion, continued pain after surgery and inability to return to prior level of sports participation. The procedure requires a one-night hospital stay and physical therapy. Most patients can return to full activity within six to nine months of surgery with appropriate post-operative care and specialized physical therapy. The CHKD Sports Medicine program takes a comprehensive approach to treating young athletes in every sport. Our team is composed of pediatric orthopedic surgeons, sports medicine primary care physicians, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists to provide the most thorough care available for ACL prevention and tears in female and male athletes. For more information on ACL surgery at CHKD or our ACL injury prevention program, call (757) 668-7529 (PLAY), or visit CHKD.org/sportsmedicine.
CHKD urologist elected treasurer of the Virginia Chapter of the Association of Women Surgeons (AWS)
Jyoti Upadhyay, MD
CHKD pediatric urologist Jyoti Upadhyay, MD, has been elected treasurer of the Virginia Chapter of the Association of Women Surgeons (AWS). She also serves on the education committee of the national group. The AWS was established in the 1980s by members of the American College of Surgeons to address the specific challenges women face in surgical careers.
Virginia was the first state to organize and incorporate a state chapter of AWS, with the goal of developing relationships among women surgeons on the local level and providing residents and students with role models and career development opportunities. “Our ultimate goal is to attract more women to surgical careers and to offer them the mentorship and support they will need to succeed,” says Dr. Upadhyay. For more information on the AWS, visit womensurgeons.org. To reach Dr. Upadhyay, call 668-7878.
CHKD Transfer Center facilitates urgent referrals The CHKD Transfer Center facilitates communications for urgent referrals to CHKD’s trauma service, emergency department, NICU, PICU or general inpatient units. To reach the service, call (757) 668-8000. The toll free number is (844) 480-8000. Calls are answered by paramedics who will obtain information from the referring provider and conference the attending CHKD physician into the call. The transfer center paramedic will stay on the line to coordinate logistical support, including activation of the CHKD transport team when needed. When calling the CHKD Transfer Center for an urgent referral, please be prepared to provide the following: • Facility and/or referring provider name and contact information • Current status of patient • Diagnosis • Service requested
Tears to the anterior cruciate ligament can generally be repaired using physeal-sparing techniques, which use a ligament graft to eliminate the risk of growth plate disturbance. Allison Tenfelde is a board-certified orthopedic surgeon at CHKD. You may reach her at (757) 668-6550.
• Patient name and date of birth For physician-to-physician consults that do not involve transfer, transport or urgent admissions, please call Doctors Direct at (757) 668-9999 or (800) 207-2022. CHKD Surgical Group | Journal | Vol. 4, 2015
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non-profit US Postage PAID Norfolk, VA Permit 1800
601 Children’s Lane Norfolk, VA 23507
Dr. Jesus “Jegit” Inciong has joined the plastic and reconstructive surgery practice of CHKD’s Surgical Group. Dr. Inciong received his medical degree from the University of the Philippines, where he also completed a residency in plastic surgery. After finishing a fellowhip in plastic surgery at the University of Southern California, Dr. Inciong completed fellowships in plastic surgery at the University of Miami and microsurgery and craniofacial surgery at Eastern Virginia Medical School. Dr. Inciong has been a longtime volunteer for Operation Smile, performing cleft lip and palate repairs all over the world and is board certified by the American Board of Plastic Surgery.
DR. JEREMY SALLER ORTHOPEDICS AND SPORTS MEDICINE
Dr. Gary Tye has joined the neurosurgery practice of CHKD’s Surgical Group. Dr. Tye received his medical degree from the Medical College of Virginia, where he also completed a residency in neurosurgery. After serving as chief resident in neurosurgery at the Medical College of Virginia, Dr. Tye completed a fellowship in pediatric neurosurgery at Cincinnati Children’s Hospital. His clinical interests include pediatric neurosurgery, tethered cord, epilepsy, brain tumors, endoscopic surgery and minimally invasive surgery.
DR. JESUS GIL B. INCIONG PLASTIC AND RECONSTRUCTIVE SURGERY
DR. GARY TYE NEUROSURGERY
CHKD Surgical Group welcomes new surgeons Dr. Jeremy Saller has joined the orthopedic surgery practice of CHKD’s Surgical Group. Dr. Saller attended medical school at Texas Tech Health Science Center in Lubbock, Texas, where he also completed his residency. He completed a fellowship at Alfred I. duPont Hospital for Children in Wilmington, Delaware, and has a clinical interest in neuromuscular disorders, limb deformity correction and spinal deformity surgery.