Pediatric Orthopaedic Division Chief Report Winter 2023

Pediatric Orthopaedic Update | Winter 2023

By Michael Glotzbecker, MD

Like most of your practices, this year has brought continued challenges as we recover from the pandemic. Nursing shortages, particularly in the OR, PICU and perioperative areas have led to a reduction in operating room access. Our Prentiss Pediatric Operating Room suites are showing early signs of recovery, and I am extremely proud of our team’s commitment to pediatric orthopaedic care despite these challenges over the past few years.

Michael Glotzbecker, MD

In the midst of this new normal, we looked back at how our outpatient clinical volumes were affected during the pandemic and now how they are recovering post vaccine availability. The total number of pediatric orthopedic visits decreased by 22.2% during the pandemic and remained 11.6% lower even after the vaccine was available compared to pre-pandemic volumes. Growth continues, however, and we deeply appreciate all of our referring physicians.

Our same day urgent/fracture care clinics led by our nurse practitioners have provided convenient access for our patients, referring pediatricians and urgent/emergency care providers. These clinics have grown exponentially and in the first full year we saw over 1,500 patients. The majority of patients have fractures that can be treated in the clinic, but we also see patients with sprains and other injuries. Most of the patients come in with new injuries, but the clinic can also provide follow-up care to ensure continuity. Families appreciate that they can walk in with an injured child, where the child can be evaluated, obtain the x-rays they need, and be definitively treated with our outstanding casting team. We know that when someone’s child is injured, they do not want to wait to get treatment. We expect growth to continue as word of mouth spreads among young families, which will allow us to expand hours and locations.

Academically, our group has remained active and continues to be incredibly productive. We present regularly at national and international meetings.  We published more than 60 articles in 2022.  We are supported by an outstanding research team including a research fellow, research coordinator, and a regulatory specialist. Additionally, we look forward to a new research nurse joining our team in early 2023.  Our surgeons are highly involved in multicenter research studies, with most holding leadership positions in those groups. With such robust research activity, we are able to mentor and integrate medical students, residents and fellows into our team. Probably the highlight from our institution is the ever expanding literature from Dr. Liu and his teams working to refine techniques to determine skeletal maturity.  Taking care of growing kids, we often need to know how much growing remains, and Dr. Liu’s team has advanced our ability to accurately understand where any given child is in their growth cycle.

We continue to strive to be at the leading edge of pediatric orthopaedic care. One area of strength is in limb deformity care with Dr. Liu leading our group regionally and in his involvement in national research studies, having served as the immediate Past President of the Limb Lengthening Research Society. EOS Edge, an advanced imaging system featuring low dose radiation capabilities while providing superior images, has been installed on our main campus at UH Cleveland Medical Center. We offer solutions for advanced spinal deformity correction from early onset scoliosis through adolescence by incorporating the newest technologies available including vertebral body tethering, Apifix, and customized casting. Our goal to utilize the most advanced technology available includes adding new technologies like Pulse Navigation, Mazor X robotic assisted spine surgery, and Firefly. These technologies make our surgeries safer and more efficient, improving the accuracy and reliability of superior patient outcomes. With more efficient surgery, our patients can recover faster and with excellent results. Our sports team offers advanced care for young athletes, whose needs are very different than those of adults because they have open growth plates. We will continue to provide the very best pediatric care for all our patients.

We are excited to welcome a new pediatric orthopaedic surgeon this fall. Katherine Hollnagel, MD will be joining UH Rainbow as a hip preservation specialist after completing fellowships in pediatric orthopaedics in San Diego and adolescent/young hip preservation in Boston. Not only will she be a national expert on taking care of young children with hip dysplasia, she will also have the tools and knowledge to treat adolescent and young adults with mild hip dysplasia or hip impingement. Understanding how and when to treat these patients may save them from requiring a joint replacement at a younger age. She will be the regional expert in this field and we are so excited about how her expertise will complement and round out our team.