Limb lengthening and reconstruction: Your child's healthcare team

Many people are involved in helping your child have a successful limb reconstruction (sometimes called limb lengthening or limb correction). Each person involved brings a set of skills and expertise to help care for and support your child. You, your child and your family will be at the centre of the healthcare team. Your involvement is essential to the success of the procedure.

Members of your child’s healthcare team

During their journey through limb lengthening or reconstruction, your child will meet with a number of people in their healthcare team.

• Orthopaedic surgeon
  
• Physical therapy practitioner
• Physiotherapists
• Orthopaedic Floor nurses
• Orthopaedic Clinic nurses
• Anaesthesiologist
• Clinical trainees (residents, fellows)
• Administrative assistants
• Orthotists
• Orthopaedic technologists
• Patient information clerks

Orthopaedic surgeon

You will meet with a surgeon at your first visit to the hospital. They will talk to you about your goals and concerns and discuss the limb reconstruction surgery options for your child, after examining your child and reviewing their X-rays.

If you choose to go ahead with limb reconstruction treatment, they will perform the surgery and manage your child’s post-operative (after surgery) care in the outpatient clinic. Your surgeon will also do any other procedures that your child needs during treatment and will remove the limb lengthening or correction device in the operating room at the end of treatment.

Physical therapy practitioner

You will briefly meet a physical therapy practitioner (PTP) at your first clinic visit. You will meet the PTP again for a detailed education session about limb reconstruction before surgery.

The PTP will monitor your child’s recovery in hospital after surgery and show you and your child how to use the device before your child goes home. The PTP will assess your child at every follow-up appointment and discuss any issues with your surgeon.

You will be able to contact the PTP with any questions about your child’s limb reconstruction treatment plan or about the device.

Physiotherapist

You will meet with a physiotherapist (PT) at your education session before surgery. The PT will:

• review what your child can already do
• find out about you and your child’s goals
• teach your child any exercises and, if needed, how to use crutches or a walker.

Before your child leaves the hospital, a PT will work with them on getting up and out of bed and starting their exercise program. Your child will meet with a PT at every follow-up appointment for an assessment, a stretching session and an update to the exercise program. Your child will need to do the exercises shown by the PT at least three times a day at home. Following the exercise program is essential to obtain an excellent result from limb reconstruction surgery.

Orthopaedic Floor nurses

The inpatient nurses on the orthopaedic floor will take care of your child after their surgery until they go home. They will help your child recover from the surgery and monitor things such as your child’s heart rate and pain level. They will also teach you how to change your child’s pin and wire site dressings when you are at home.

Orthopaedic Clinic nurses

The orthopaedic clinic nurses will talk to you about how to prepare for surgery and what to expect when you come to the hospital. They will talk with you during your child’s follow-up appointments and work with your surgeon to help care for your child.

Anaesthesiologist

You will meet with an anaesthesiologist before going for surgery. The anaesthesiologist is there to give your child the medicine that puts them to sleep. It is important for them to know about any allergies or conditions that your child may have. They can also address any concerns about being put to sleep for the surgery.

This doctor is responsible for your child’s safety and wellbeing while they are asleep for their surgery. They will stay with your child the whole time.

Another important job of the anaesthesiologist is to deal with any pain from the operation. They help make a plan with you and the surgeon about how to give your child pain relief. They have a lot of different ways to make sure your child is comfortable when they wake up from the anaesthesia.

Clinical trainees

Clinical trainees include orthopaedic clinical fellows and residents.

• Fellows are fully qualified orthopaedic surgeons who have chosen to spend extra time working alongside your child’s surgeon to learn advanced techniques before they start their own surgical practice.
• Orthopaedic residents are doctors who have completed medical school and are being trained in orthopaedic surgery.

Fellows and residents will both be involved in your child’s care while your child is going through limb reconstruction treatment.

Administrative assistants

The administrative assistants work with the surgeons to organize your care. They will call you to confirm your child’s surgery appointment and tell you how to prepare for the day of surgery.

Orthotists

An orthotist is someone trained to make and manage orthotics. These are supports that can guide, help, control or limit how certain parts of the body move.

Your child will meet with an orthotist if they need an orthotic such as a foot, ankle or knee support. The supports are usually created while your child is in hospital and can be adjusted during your child’s routine follow-up appointments.

Orthopaedic technologists

If your child needs a cast to protect their limb, you will meet a registered orthopaedic technologist. This person specializes in putting on casts and removing them safely. An orthopaedic technologist may be involved in your child’s care during surgery, while in hospital or at follow-up appointments.

Patient information clerks

The patient information clerks will be the first people you meet when you arrive at the hospital. They will register your child and tell you where to go at each of your appointments.

Other services that may be involved in your child’s care

Social work

As you plan for your child's treatment before their limb reconstruction surgery, it is important to consider how you can support your child through their patient journey. You are welcome to speak to a social worker at the hospital if you have concerns about either your or your child’s emotional or social wellbeing before, during or after treatment.

Child life specialists

Having limb lengthening and reconstruction surgery and staying in the hospital can be scary for children. Child life specialists use play as a tool to help make your child's experience as positive as possible. You can access this service at any point during your journey.

Pain team

Some hospitals have a team of health care professionals who can help your child to manage pain. They are often involved when a child is in the hospital after surgery but may be needed at other times during treatment.