Orthopedic Outpatient Clinic
Kennedy Krieger Institute, 801 North Broadway, Baltimore, MD 21205
Director:
The Orthopedic Outpatient Clinic is an outpatient program that evaluates children from infancy into early adulthood. The orthopedic team, along with the physical therapists, evaluates the child for orthopedic problems such as gait disorders, subluxation of the hips, and scoliosis. Unique to Kennedy Krieger Institute is the ability to combine operative care with intensive post-operative physical therapy, maximizing surgical benefit.
The primary goals of the clinic are to provide the following:
“Jimmy” is a 6-year-old little boy with cerebral palsy affecting both of his legs. Jimmy walked with a walker since age 2, and used braces on his feet and ankles. His mother started to notice that Jimmy’s legs crossed over each other instead of going straight ahead, and that he walked with his knees bent. Jimmy’s therapist thought that he had stopped making progress in physical therapy and she was concerned as well.
Jimmy came to Kennedy Krieger and was seen in orthopedic clinic for evaluation. He was examined and noted to have limited movement of his leg out to the side. X-rays were taken of his hips and spine; they showed that both hips were starting to move out of the sockets. Jimmy’s mother was told that this was a common problem in children with cerebral palsy, because of muscle imbalance around the hip joints. Jimmy and his mother also were told that the muscles around the hips, knees and ankles had what were called fixed contractures that were preventing him from walking as well as he could. Surgery on the muscles was recommended.
Jimmy’s mother met other children who had benefited from surgery, and although she wished Jimmy did not need to have an operation, she also wanted him to be the best at walking that he could be. Jimmy was nervous about surgery. Before his surgery, he met with the child life specialist, who gave him a tour of the hospital and prepared him so he knew what to expect on the day of his surgery. Jimmy met his nurse and his inpatient therapist as well. He even told his mother not to worry.
Jimmy had surgery at Johns Hopkins Hospital and stayed at the Children’s Center at Hopkins for a few days. His mother stayed with him. Once he felt like himself he was transferred to Kennedy Krieger Hospital where his physical therapy started immediately. After a week in the hospital, he went home in a wheelchair to do the exercises he learned with his mother. When Jimmy was six weeks out from surgery, he came back to Kennedy Krieger to have his cast removed. He was stiff from not moving for so long so his therapy was intensive, but after a few days he felt great and was back walking using his walker and his braces. Jimmy noticed a difference when he walked after the surgery; it felt much easier to him to move his legs and he didn’t feel as tired as he had before surgery. His mother was pleased too. She noticed that Jimmy’s legs tended not to cross over. Jimmy still had problems with his balance but now he was walking with his foot flat and his knees were straight. He even appeared taller when he stood. Jimmy started to make more progress again in therapy; in fact his therapist thought that Jimmy was ready to try walking with crutches instead of his walker!
The primary goals of the clinic are to provide the following:
- Diagnostic assessment of orthopedic problems
- Orthopedic management of the patient with the physical therapy team
- Ongoing treatment and follow-up of orthopedic issues using both physical examination and radiographic techniques
- Surgical intervention and post-operative care
- Botox injections for spasticity
“Jimmy” is a 6-year-old little boy with cerebral palsy affecting both of his legs. Jimmy walked with a walker since age 2, and used braces on his feet and ankles. His mother started to notice that Jimmy’s legs crossed over each other instead of going straight ahead, and that he walked with his knees bent. Jimmy’s therapist thought that he had stopped making progress in physical therapy and she was concerned as well.
Jimmy came to Kennedy Krieger and was seen in orthopedic clinic for evaluation. He was examined and noted to have limited movement of his leg out to the side. X-rays were taken of his hips and spine; they showed that both hips were starting to move out of the sockets. Jimmy’s mother was told that this was a common problem in children with cerebral palsy, because of muscle imbalance around the hip joints. Jimmy and his mother also were told that the muscles around the hips, knees and ankles had what were called fixed contractures that were preventing him from walking as well as he could. Surgery on the muscles was recommended.
Jimmy’s mother met other children who had benefited from surgery, and although she wished Jimmy did not need to have an operation, she also wanted him to be the best at walking that he could be. Jimmy was nervous about surgery. Before his surgery, he met with the child life specialist, who gave him a tour of the hospital and prepared him so he knew what to expect on the day of his surgery. Jimmy met his nurse and his inpatient therapist as well. He even told his mother not to worry.
Jimmy had surgery at Johns Hopkins Hospital and stayed at the Children’s Center at Hopkins for a few days. His mother stayed with him. Once he felt like himself he was transferred to Kennedy Krieger Hospital where his physical therapy started immediately. After a week in the hospital, he went home in a wheelchair to do the exercises he learned with his mother. When Jimmy was six weeks out from surgery, he came back to Kennedy Krieger to have his cast removed. He was stiff from not moving for so long so his therapy was intensive, but after a few days he felt great and was back walking using his walker and his braces. Jimmy noticed a difference when he walked after the surgery; it felt much easier to him to move his legs and he didn’t feel as tired as he had before surgery. His mother was pleased too. She noticed that Jimmy’s legs tended not to cross over. Jimmy still had problems with his balance but now he was walking with his foot flat and his knees were straight. He even appeared taller when he stood. Jimmy started to make more progress again in therapy; in fact his therapist thought that Jimmy was ready to try walking with crutches instead of his walker!
Hours of Operation:
Dr. Arabella Leet, M.D.: Wednesday, 8:30 a.m. - 4:00 p.m.
Dr. Charles Silberstein, M.D.: Thursday, 8:00 a.m. - 1:30 p.m.
Dr. Paul Sponseller, M.D.: Friday, 8:30 a.m. - 10:45 a.m.
Dr. William Baugher, M.D.: 3rd Thursday of the month, 9:00 a.m. - 11:00 a.m.
Dr. Charles Silberstein, M.D.: Thursday, 8:00 a.m. - 1:30 p.m.
Dr. Paul Sponseller, M.D.: Friday, 8:30 a.m. - 10:45 a.m.
Dr. William Baugher, M.D.: 3rd Thursday of the month, 9:00 a.m. - 11:00 a.m.
Contacts:
To make a referral or request an initial evaluation:
Contact our Care Management Office
Toll-Free Referral: (888) 554-2080
Local Referral: (443) 923-9400
For follow-up appointments:
Nicole Braswell
Phone: (443) 923-2700
braswell@kennedykrieger.org
Contact our Care Management Office
Toll-Free Referral: (888) 554-2080
Local Referral: (443) 923-9400
For follow-up appointments:
Nicole Braswell
Phone: (443) 923-2700
braswell@kennedykrieger.org
Developmental Delay
Genetic Disorders
Neuromuscular Disorders
Shaken Baby Syndrome
Brain Injury
Spina Bifida
Down Syndrome
Birth Defects
Osteogenesis Imperfecta (OI)
Movement Disorders
Neurodegenerative disorders
Spinal Cord Injury
·Assistive Technology Clinic
·Ataxia Telangiectasia Clinic
·Botulinum Toxin Treatment Program
·Cerebral Palsy and Neurodevelopmental Medicine Center
·Holoprosencephaly and Related Malformations Center
·Movement Disorders Program (MDP)
·Occupational Therapy Clinic
·Osteogenesis Imperfecta Clinic
·Pediatric Rehabilitation Clinic
·Pediatric Rehabilitation Continuum
·Pediatric Rehabilitation Unit (PRU)
·Physical Therapy Clinic
·Spina Bifida and Related Conditions, Philip A. Keelty Center for
·Ataxia Telangiectasia Clinic
·Botulinum Toxin Treatment Program
·Cerebral Palsy and Neurodevelopmental Medicine Center
·Holoprosencephaly and Related Malformations Center
·Movement Disorders Program (MDP)
·Occupational Therapy Clinic
·Osteogenesis Imperfecta Clinic
·Pediatric Rehabilitation Clinic
·Pediatric Rehabilitation Continuum
·Pediatric Rehabilitation Unit (PRU)
·Physical Therapy Clinic
·Spina Bifida and Related Conditions, Philip A. Keelty Center for
The Resource Finder: A Project of Kennedy Krieger Institute
United Cerebral Palsy
(http://www.ucpa.org/)
Medtronic
(www.medtronic.com)
Understanding Disabilities, Creating Opportunities
(www.ucp.org)
Pediatric Orthopedic Society of North America
(http://www.posna.org)
Outpatient Programs l Inpatient Programs l Community Programs l
Continuums l Genetic Laboratories l Clinical Disciplines/Depts.
United Cerebral Palsy
(http://www.ucpa.org/)
Medtronic
(www.medtronic.com)
Understanding Disabilities, Creating Opportunities
(www.ucp.org)
Pediatric Orthopedic Society of North America
(http://www.posna.org)
Continuums l Genetic Laboratories l Clinical Disciplines/Depts.