Research seeks new treatment options, standards of care

Investigators at Le Bonheur Children’s and Campbell Clinic are working to develop

new options for evaluating and treating children with orthopaedic disorders

and injuries. Some of the highlights of the program include:

Study: Genetic AIS test for African AmericansResearchers are leading studies to develop a genetic test that can predict

progression of adolescent idiopathic scoliosis in African Americans.

Le Bonheur serves

as a leading center for

the project, sponsored

by Axial Biotech, which

began this summer. In the

first phase of the study,

researchers will study the

spinal curvature progres-

sion of African-American

adolescents who have

completed treatment for

scoliosis. The study will

analyze the genetic pro-

file of those adolescents,

comparing it to their

progression, to better

understand correlations

in the profiles. All variances of spinal curvatures will be studied.

In the second phase of research, investigators will gather DNA profiles of

new African-American patients and follow their curvature until maturity.

Genetic testing known as SCOLISCORE tests are currently available for

Caucasians and helps physicians predict curve progression for these patients. In

turn, physicians are able to determine the most appropriate care for each child.

“Our hope is that we will be able to develop a test that will help us predict

spinal curvature progression in African Americans with adolescent idiopathic scoliosis,”

said Jeffrey R. Sawyer, MD, an investigator of the project. “This test enables us to

design treatment for each of individual patient, giving them the best options for care.”

Principal investigators on the study are Jeffrey R. Sawyer, MD; William Warner,

Jr., MD; and Derek Kelly, MD.

Study: Kickstand modification useful for lower extremity elevation

Research recently published in the Journal of Children’s Orthopaedics shows

that kickstand modification is a useful tool to ensure lower extremity elevation

in children, and can be effective in ensuring compliance and preventing

pressure sores.

The study

(“Kickstand modifica-

tion for external

fixation of lower

extremity fractures

in children,” Journal

of Child Orthopaedics

2011, 5:63-67) was authored by Jeffrey R. Sawyer, MD; James Beaty, MD;

Derek Kelly, MD; William Warner, Jr., MD; Leslie Rhodes, NP; and Terry Canale, MD.

Summer 2011

lebonheur.org

campbellclinic.com

Case study: Ashlie Bradford, spinal tumor

For nearly a year and a half, 12-year-old Ashlie Bradford slowly lost strength in her legs until she couldn’t walk. The avid bicycle rider who loved the out-

doors couldn’t stay on her bike anymore.

The Bradfords, from Muscle Shoals, Ala., would see nine doctors before a Huntsville neu-

rologist found a spinal column tumor involving T8 and T9 levels with severe compression of the spinal cord. Stability of her spine was compromised and she had a kyphotic deformity. Ashlie was referred to Pediatric Neurosurgeon Paul Klimo of Semmes Murphey Neurosurgery, who worked with fel-low Neurosurgeon Michael Muhlbauer, MD, and Campbell Clinic Orthopaedic Surgeon William Warner, Jr., MD, to resect the tumor and decompress the spinal cord. Warner then stabilized her spine with rods/screws and bone from her hip.

Surgeons were able to use O-arm surgical imaging technology to provide real-time, intraoperative CT imaging.

O-arm technology provides both 2D fluoro and 3D multi-planar reconstructed orthogonal images of bone anatomy. The system can also integrate with Medtronic’s StealthStation surgical navi-gation systems to confirm the precision hardware ther-apy placement in advanced surgical procedures.

“Ashlie had very narrow bony channels where the screws would be placed. The O-arm allowed us to place the screws very accurately and thus safely,” Klimo said.

Added Warner: “Using the surgical navigation allowed us to safely place pedicle screws in a very narrow pedicle. Without the surgical navigation it would have been very difficult to safely place these pedicle screws and we would not have been able to obtain as secure fixation to stabilize Ashlie’s spine.”

The O-arm also allowed surgeons to see how well they removed the tumor, which involved bone in her vertebra.

Klimo and Warner were able to leave the operating room knowing the hard-ware was safely in place and the tumor appeared to be completely removed around the spinal cord and from the

vertebral body. “One month after surgery, Ashlie is

now ambulating independently with a cane and we expect her to make a full recovery,” Warner said. “We were also able to obtain 50 percent correction of her kyphotic deformity (round back) that was the result of vertebral body destruction from the tumor.”

Ashlie Bradford

O-arm CT scan of screw placement. O-arm CT scan of screw placement.

Memphis, Tennessee

PeDiATriC OrTHOPAeDiCS

Genetic testing helps predict curvature outcomesSurgeons at Campbell Clinic and Le Bonheur are

now using SCOLISCORE to help predict progression in Caucasian patients.

A good candidate for the test is a 9- to 13-year-old child with a mild curve up to 30 degrees who has recently been diagnosed with adolescent idiopathic scoliosis (AIS), said Jeffrey R. Sawyer, MD.

“With moderate progression, I can use the SCOLISCORE test in these cases to predict curvature. If the score is high, I will recommend we brace early to prevent deformity,” Sawyer said.

On the other hand, an older child with a low SCOLISCORE may not need bracing, as the test tells Sawyer the curve is unlikely to progress more.

“It also enables us to cut down on X-rays, because we have a good predictor on how fast the curvature will progress, Sawyer said.

continued on page 2

Authors followed eight patients for 24 months who suffered from severe lower extremity

trauma. Kickstands were applied in less than 15 minutes at the conclusion of surgical

procedures where external fixator frames were assembled after pins were placed in the

appropriate locations based on the fracture configuration and soft-tissue injuries. The

kickstand ensured elevation, eliminated the need for splint or cast change, was lightweight

and adjustable, and provided for circumferential access in wound care and neurovascular exams.

Investigators found all patients tolerated the device and none suffered from pressure sores or

complications related to the device.

Study: Lateral radiographs justified in Sever diseaseResearch evaluating the necessity of radiographic evaluation in children with calcaneal

apophysitis, known also as Sever disease, found that routine lateral radiographs are justified.

Published in the Journal of Pediatric Orthopaedics, (“Is Radiographic Evaluation Necessary in

Children With a Clinical Diagnosis of Calcaneal Apophysitis (Sever Disease),” 2011; 31:548-550.),

the study reviewed clinical records and radiographs of 98 patients whose chief complaint

was heel pain. Findings suggested that despite concern about radiation exposure and cost of

imaging, radiographs should be obtained to rule out abnormalities, such as lesions, that could

require more aggressive treatment.

Research fellow, coordinator join teamLe Bonheur and Campbell Clinic have added a new OREF research fellow and clinical

research coordinator to assist with more research.

Nelson Astur will begin his pediatric spine research fellowship

at Le Bonheur and Campbell Clinic, in a program funded

by the Orthopaedic Research and Educational Foundation. Astur

completed a spine fellowship and orthopaedics residency at Santa

Casa School of Medicine in Sao Paulo, Brazil. Astur will help oversee

multiple scoliosis studies at Le Bonheur and Campbell Clinic.

Alice Ruch is an orthopaedic clinical research coordinator. Ruch

assists with all aspects of orthopaedic research, including Institutional

Review Board (IRB) submission of prospective and retrospective

studies, subject enrollment and tracking, data retrieval, documenta-

tion, etc. She is currently assisting with studies in VEPTR, clubfoot

and scoliosis.

Ruch has a bachelor of nursing degree from Baptist College of

Health Sciences and is a member of Sigma Theta Tau International

Nursing Honor Society. She most recently served at InMotion

Orthopaedic Research Center.

NuRSe pRActItIoNeRS pReSeNt ReSeARch, expeRtISe

Nurse practitioners with

Le Bonheur Children’s Hospital

are sharing their research about

fractures and slipped capital

femoral epiphysis with other

clinicians.

Leslie N. rhodes, PNP-BC,

co-authored “Use of a ‘kick-

stand’ modification” for external

fixation of lower extremity

fractures in children” in the February 2011 issue of Journal of Children’s

Orthopaedics with Campbell Clinic Orthopaedic Surgeons Jeffrey r.

Sawyer, MD, Derek M. Kelly, MD, James H. Beaty, MD, S. Terry Canale,

MD, and William C. Warner Jr., MD.

rhodes and Donna C. Scott, PNP-BC, presented at the 13th Annual

Pre-Brandon Carrell Pediatric Orthopaedic Symposium at Texas Scottish

rite Hospital for Children. Scott presented “Pediatric Fracture Clinics:

Current Status and Future Directions,” which highlighted the essential

components for a high-volume, multidisciplinary fracture clinic.

rhodes presented “Current Management of slipped capital femoral

epiphysis,” a common childhood disorder of the hip. SCFe is often misdi-

agnosed because of initial presentation of knee pain and limping.

She discussed the diagnosis, classification and treatment options.

rhodes also facilitated a round table discussion on pediatric sports

medicine at the 2011 Pediatric Orthopaedic Practitioner’s Society

Annual Conference held in conjunction with the Pediatric Orthopaedic

Society of North America’s annual conference.

Orthopaedic Symposium set for Nov. 5

Le Bonheur Children’s will host its annual Pediatric

Orthopaedic Symposium on Saturday, Nov. 5, at

Le Bonheur Children’s Hospital. The conference, entitled

“Common Conditions and Injuries of the Lower Extremity

in Children and Adolescents,” will feature Le Bonheur and

Campbell Clinic pediatric orthopaedic surgeons.

The symposium will feature guest speaker Steven Frick, MD,

a pediatric orthopaedic surgeon at the Levine Children’s Hospital

and residency program director for the Department of Surgery

at the Carolinas Medical Center in Charlotte, NC. Frick is the

current chair of the Leadership Development Committee of

both the American Academy of Orthopaedic Surgeons and the

American Orthopaedic Association.

Conference topics will address common conditions and

injuries of the foot and ankle, and hip. Specific topics include:

Pain in the foot: what to do? Osteochondroses of the footWilliam C. Warner, Jr., MD

Clubfoot: Ponseti casting, French method, surgical correction? How to choose the best treatment optionSteven L. Frick, MD

Newborn flatfeet: what to treat and what to referDerek M. Kelly, MD

Other disorders of the pediatric foot: hallux valgus, polydactyly, metatarsus adductus, other congenital deformitiesJeffrey R. Sawyer, MD

Sports injuries of the foot and ankleJames H. Beaty, MD

Office orthopaedics: what to do for the child with a foot problem?Leslie Rhodes, RN

Developmental dysplasia of the hipSteven L. Frick, MD

Legg-Calvé-Perthes disease: diagnosis and treatmentJames H. Beaty, MD

Slipped capital femoral epiphysisJeffrey R. Sawyer, MD

Hip preservation in the adolescent: surgical dislocation and Ganz osteotomy Derek M. Kelly, MD

Hip arthroscopy in children and adolescentsMarc J. Mihalko, MD

The “snapping” hip: diagnosis and treatmentWilliam C. Warner, MD

For more information about the conference, visit www.methodistmd.org.

Nelson Astur

Alice Ruch

Donna C. Scott, PNP-BC and Leslie N. Rhodes, PNP-BC

continued from on page 1

Case study: china Jones, slipped capital femoral epiphysis

China Jones’ hip used to freeze up if she sat on

the floor for longer than 15 minutes. Walking for 10

minutes would cause so much pain the 11-year-old

would cry. For two years, China was homebound and

missed going to school on a daily basis. Her mother,

Lisa, says China struggled with anger and depression.

China’s pain was caused by residual deformity

after slipped capital femoral epiphysis (SCFE).

SCFE commonly affects children between the ages

of 10-14. Untreated, it can lead to severe pain, deformity, and osteo arthritis possibly

requiring a hip replacement.

Surgeons at Le Bonheur Children’s and Campbell Clinic tried several noninvasive treat-

ments and four surgeries to relieve pain and prevent the femur from slipping. The next step was

an intertrochanteric femoral osteotomy, which posed some challenges to the surgical team.

Because China had a screw in her hip already, the orthopaedic team couldn’t get an MRI to

determine if China had a labral tear, which Orthopaedic Surgeon Derek Kelly, MD suspected.

To eliminate the need for two surgeries, Kelly partnered with Campbell Clinic Orthopaedic

Surgeon Marc Mihalko, MD, who

specializes in hip arthroscopy. Under

one anesthetic, Mihalko was able to

diagnosis and repair the torn labrum.

Kelly then performed an intertrochan-

teric femoral osteotomy to realign the

deformity. By performing the procedures

together, Campbell Clinic surgeons hope

they have eliminated China’s pain and

prevented her from developing arthritis

which could require a hip replacement

down the road.

At her two week follow-up

visit, China grinning from ear to ear

announced she was pain-free. When

China will no longer need to use a

wheelchair or walker, her family plans

to take a trip to Hot Springs.

”Dr. Kelly is always willing to take

the extra time to attend to whatever

questions or concerns we have,” Lisa said.

“He gave us a heads up on everything

that will happen and what to expect

with China. We know we have a long

way to go.”

China Jones

In situ pinning

Le Bonheur Orthopaedics joins U.S. News “best hospital” ranks

The orthopaedic program at Le Bonheur Children’s was named in 2011 as one of the country’s best by

U.S. News & World Report. Le Bonheur also earned designations in cardiology

and heart surgery, neurology and neurosurgery and nephrology.

“The children we care for count on us to be the best. We have taken that responsibility very seriously and are thrilled to be recognized by the experts at U.S.

News & World Report,” said Le Bonheur President and CeO Meri Armour. “We will continue to provide excellent care for children for years to come.”

establishing Le Bonheur among the nation’s top children’s hospital has been a vision since 2005, and Le Bonheur has used the survey as a benchmarking tool since 2007. Le Bonheur has focused on creating multi-disciplinary programs, implementing quality improvement initiatives and investing in technology.

Case study: William “Drews” Andrews, trauma

During a trip to his family’s Mississippi farm,

12-year-old William “Drews” Andrews was riding in

the woods with friends when the dirt bike he was

driving collided head-on with an all-terrain vehicle

(ATV). A helmet might have saved Drews’ life, but it

didn’t save him from serious injury.

“When we got to him, we could tell his left

arm was mangled,” said mom, Maureen Andrews.

“We couldn’t see how badly his leg was hurt

because he was wearing jeans.”

Drews’ parents rushed him to the nearest

emergency room in Oxford, Miss. Knowing

immediate surgery was necessary, doctors transferred him to Le Bonheur Children’s Hospital

via helicopter.

Once at Le Bonheur, X-rays revealed a badly broken left

tibia and fibula, a fractured left proximal tibial physis and a

broken left radius and ulna.

According to Campbell Clinic Pediatric Orthopaedic Surgeon

James Beaty, MD, Drews underwent surgery to repair a growth

plate injury of the upper tibia, rodding of the forearm fractures

and casting of the tibial and fibular shaft fractures.

“Drews had such a positive attitude and a great

support network of family and friends,” said Beaty.

Drew spent four months going through rehabilitation

while his fractures healed. Beaty continued to monitor his

recovery, and Drews received ongoing physical therapy.

“The level of care we got from the very beginning at

Le Bonheur helped us see the positive and know Drews

would be OK,” said mom, Maureen.

Drews underwent four surgeries in all. The final one

was leg-length equalization because of the severe injury to

the upper tibial growth plate.

Because of the growth plate injury, it was uncertain

whether Drews — from a family of tall men — would grow

to reach his full height potential. Now 15 and an upcoming high

school freshman, Drews is already 6 feet tall. He has no physical

limitations from the accident and is a star basketball player.

“His outcome is truly a testimony to the care provided

at Le Bonheur and to God,” said Maureen.

Drews Andrews

Intertrochanteric valgus flexion derotation osteotomy

Multiple trauma with fractures of the radius and ulna, the proximal tibial growth plate

and the shafts of the tibia and fibula

Non-Profit Org.

US POSTAGEPAID

Memphis, TNPermit No. 3093

50 N. Dunlap StreetMemphis, Tennessee 38103

Research, publications and presentationsLe Bonheur Children’s Hospital and Campbell Clinic’s four surgeons are actively involved in research and presentations in the pediatric orthopaedic field. Highlights from their work are listed below:

publicationsWarner Jr. WC, Sawyer JR: Kyphosis In Lovell and Winter’s Pediatric Orthopaedics 7th

Edition. Submitted for Publication.

Rachel JN, Williams JB, Sawyer JR, Warner Jr WC, Kelly DM (2011) Is RadiographicEvaluation Necessary in Children with a Clinical Diagnosis of Calcaneal Apophysitis(Sever Disease)? Journal of Pediatric Orthopaedics, 31:548-550.

Sawyer JR, Kelly DM, Beaty JH, Warner Jr. WC, Canale ST (2011) Kickstand Modification for External Fixation of Lower Extremity Fractures in Children. Journal of Children’s Orthopaedics, 5:63-67.

Cross JD, Rush JK, Kelly DM, Warner Jr, WC, Sawyer JR (2010) The Treatment of Pediatric Lower Extremity Deformity Using the Taylor Spatial Frame. Current Orthopaedic Practice, 22 (2): 135-141.

Beaty, J.H. (2010). Fractures of the lateral humeral condyle are the second mostfrequent elbow fracture in children. Journal of Orthopaedic Trauma, 24(7):438.No abstract available. PMID: 2057707

Anand, K.J., Eubanks, J.W. 3rd, Kelly, D.M., Meier, J.W., Saltzman, J.A., Crisler, S.C., Kraus, G.J., Spentzas, T. & Chesney, R.W. (2010). Pediatric Patients Seen in Port-au-Prince, Haiti. Clinical Pediatrics (Phila). 2010 Aug 19. [Epub ahead of print]

Sawyer, J.R., Kellum, E.L., Creek, A.T. and Wood, G.W. 3rd. (2010) Acute compartmentsyndrome of the hand after a wasp sting: a case report. Journal of PediatricOrthopaedics, 19(1):82-5.

Sawyer, J.R., Ivie, C.B., Huff, A.L., Wheeler, C., Kelly, D.M., Beaty, J.H. & Canale, S.T.(2010). Emergency room visits by pediatric fracture patients treated with castimmobilization. Journal of Pediatric Orthopaedics, 30(3):248-52.PMID: 20357591

Katz, D.E., Herring, J.A., Browne, R.H., Kelly, D.M. & Birch, J.G. (2010)Brace wear control of curve progression in adolescent idiopathic scoliosis. Journal of Bone and Joint Surgery, American edition, 92(6):1343-52.

Kelly, D.M., McCarthy, R.E., McCullough, F.L. & Kelly, H.R. (2010). Long-term out-comes of anterior spinal fusion with instrumentation for thoracolumbar and lumbar curves in adolescent idiopathic scoliosis. Spine (Philadelphia, Pa. 1976), 35(2):194-8.

Sawyer JR, Kellum EL, Kelly DM, Warner Jr WC (2009) Orthopaedic Aspects of All-Terrain Vehicle Accidents. Accepted for publication - Journal of the American Academy of Orthopaedic Surgeons

Lee, M.C., Kelly, D.M., Sucato, D.J. & Herring, J.A. (2009). Familial bilateralosteochondritis dissecans of the femoral head. A case series. Journal of Bone andJoint Surgery, American edition. 91(11):2700-7. No abstract available.

Sawyer JR, Ivie C, Huff A, Kelly DM, Warner Jr WC, Beaty JH, Canale ST: (2009)Unplanned Emergency Room Visits by Children Treated with Cast Immobilization.Journal of Pediatric Orthopaedics 30(3): 248-52.

Sawyer, J.R., Kapoor M., Gonzales M.H., Warner W.C. Jr., Canale S.T. & Beaty J.H. (2009). Heterotopic ossification of the hip after non-accidental injury in a child: case report. Journal of Pediatric Orthopaedics, 29(8):865-7.PMID: 19934700

Beaty, J.H. (2009). The future of orthopedics. Journal of Orthopaedic Science,14(3):245-7. Epub 2009 Jun 5. No abstract available. PMID: 19499288Rhodes LN, Huff AL, Kelly DM, Warner WC, Sawyer JR. (2009) Pediatric Fracture Clinics: Current Status and Future Directions. Pediatric Health 3:439-444.

Sawyer, J.R. & Kapoor, M. (2009). The limping child: a systematic approach to diagnosis. American Family Physician, 79(3):215-24. Review.

Sawyer JR, Hicks J, Beaty JH, Canale ST, Warner Jr. WC, Beaty JH (2009) The Hammerlock Position for Treatment of Medial Epicondyle Fractures”. Current Orthopaedic Practice 20(5):572-4 .

Beebe MJ, Kelly DM, Warner Jr. WC, Sawyer JR (2009) Current Controversies in theTreatment of Pediatric Femur Fractures. Current Orthopaedic Practice 20(6):634-9.

Pershad, J., Williams, S., Wan J. & Sawyer, J.R. (2009). Pediatric distal radial fracturestreated by emergency physicians. The Journal of Emergency Medicine, 37(3):341-4.Epub 2009 Feb 6.

Kahn S, Sawyer JR, Pershad J. (2009) Prospective Randomized Comparison of Pediatric Forearm Fractures Reduced by Pediatric Emergency Room Physicians. Accepted for publication – Academic Emergency Medicine.

Heck R.K., Jr., Sawyer J.R., Warner W.C. & Beaty J.H. (2008). Progressive valgusdeformity after curettage of benign lesions of the proximal tibia. Journal of PediatricOrthopaedics, 28(7):757-60.PMID: 18812903

Beaty, J.H. (2008). Unusual doesn’t mean unusable: why information about uncom-mon injuries or conditions is important. American Journal of Orthopedics (Belle Mead N.J.), Jun;37(6):E107, E119. No abstract available. PMID: 18716699

Kellum, E., Creek, A., Dawkins, R., Bernard, M. & Sawyer, J.R. (2008). Age-relatedpatterns of injury in children involved in all-terrain vehicle accidents. Journal of Pediatric Orthopaedics, 28(8):854-8.

Richards, B.S., Beaty, J.H., Thompson, G.H., & Willis, R.B. (2008). Estimating theeffectiveness of screening for scoliosis. Pediatrics, 121(6):1296-7; author reply 1297-8. No abstract available. PMID: 18519508

Babb, J.R., Ahn, J.I., Azar, F.M., Canale, S.T. and Beaty J.H. (2008). Transphyseal anterior cruciate ligament reconstruction using mesenchymal stem cells. American Journal of Sports Medicine, 36(6):1164-70. Epub 2008 Mar. 19.PMID: 18354144

Kapoor, M., Laham, S.G. & Sawyer, J.R. (2008). Children at risk identified in an urbanscoliosis school screening program: a new model. Journal of Pediatric Orthopaedics,17(6):281-7. 18.

Golden, D.W., Wojcicki, J.M., Jhee, J.T., Gilpin, S.L., Sawyer, J.R. & Heyman, M.B. (2008). Body mass index and elbow range of motion in a healthy pediatric population: a possible mechanism of overweight in children. Journal of Pediatric Gastroenterol Nutrition, 46(2):196-201.

Golden, D.W., Jhee, J.T., Gilpin, S.P. & Sawyer, J.R. (2007). Elbow range of motionand clinical carrying angle in a healthy pediatric population. Journal of PediatricOrthopaedics, 16(2):144-9.

Arkader, A., Friedman, J.E., Warner, W.C. Jr &Wells, L. (2007).Complete distal femoralmetaphyseal fractures: a harbinger of child abuse before walking age. Journal ofPediatric Orthopaedics, 27(7):751-3.

Arkader, A., Warner, W.C. Jr, Horn, B.D., Shaw, R.N. & Wells, L. (2007). Predicting theoutcome of physeal fractures of the distal femur. Journal of Pediatric Orthopaedics,27(6):703-8.

Beaty, J.H. (2007). Presidential address: “building the best . . . Lifelong learning”. Journal of the American Academy of Orthopaedic Surgeons, 15(9):515-8. No abstract available. PMID: 17761607

presentations

Jim Beaty, MD

Beaty, Jim. Developing Teaching Skills to Enhance Learning. Presented at the American Academy of Orthopaedic Surgeons, San Diego, Calif., February 2011.

Beaty, Jim. The Orthopaedic Lecture. Presented at the American Academy of Orthopaedic Surgeons, Annual Meeting, New Orleans, La., March 9-12, 2010.

Beaty, Jim. Fractures of the Lower Extremity in Children - Staying out of Trouble. Presented at the American Academy of Orthopaedic Surgeons, Annual Meeting, New Orleans, La., March 9-12, 2010.

Beaty, Jim. Fractures of the Shoulder in the Adolescent Athlete. Presented at theAmerican Academy of Orthopaedic Surgeons, Annual Meeting, New Orleans, La.,March 9-12, 2010.

Beaty, Jim. Elbow Fractures in Children – What is Really New. Visiting Professor, Presented ge of Georgia, Augusta, Ga., Nov. 19-22, 2009.

Beaty, Jim. Musculoskeletal Infections in Children and Adolescents: Current Concepts.Visiting Professor, Presented at the Medical College of Georgia, Augusta, Ga., Nov. 19-22, 2009.

Beaty, Jim. Tarsal Coalition: Diagnosis and Treatment Visiting Professor. Presentedat the Medical College of Georgia, Augusta, Ga., Nov. 19-22, 2009.

Beaty, Jim. Pediatric Fractures – What is Really New? Visiting Professor, Presented at the Philadelphia Orthopaedic Society – Howard Steele, Philadelphia, Pa., Oct., 5, 2009.

Beaty, Jim. Fractures of the Hip in Children and Adolescents. Visiting Professor, Presented at the Drexel Department of Orthopaedics, Oct. 5, 2009.

Beaty, Jim. Fractures About the Elbow in Children – Treatment and Complications 2009.Visiting Professor, Presented at the Carolina’s Medical Center, Charlotte, N.C.,June 19, 2009.

Beaty, Jim. Changes in the Academic and Private Practice Arena. Presented at theAmerican Academy of Orthopaedic Surgeons, Board of Directors, Rosemont, Ill.,May 13-16, 2009.

Beaty, Jim. The Asheville Forum Physician Perspective. Presented at the AmericanAcademy of Orthopaedic Surgeons, Board of Directors, New York, NY, May 2009

Beaty, Jim. Leadership Qualities and Initiatives. Presented at the American Academy of Orthopaedic Surgeons, Rosemont, Ill, Oct. 15-17, 2009.

Beaty, Jim. Pediatric Orthopaedic Trauma Now and the Futur.e Presented at the Pediatric Orthopaedic Society of North America Annual Meeting, Boston, Mass., April 29, 2009.

Beaty, Jim. Elbow Fractures in Children. What have I learned? Presented at the Montreal Hospital, Montreal, Canada, Nov. 19-21, 2008.

Beaty, Jim. Femur and Hip Fractures in Children. Presented at the Montreal Hospital,Montreal, Canada, Nov. 19-21, 2008.

Beaty, Jim. Orthopaedic On-Call Crisis in the United States. Presented at the MontrealHospital, Montreal, Canada, Nov. 19-21, 2008.

Beaty, Jim. Elbow Fractures in Children... What Have I Learned? Visiting Professor,Presented at the University of Montreal, Canada, November 2008.

Beaty, Jim. Femur and Hip Fractures in Children... Horses and Zebras. Visiting Professor,Presented at the University of Montreal, Canada, November 2008.

Beaty, Jim. SCFE. Current Treatment and Complications. Visiting Professor, Presented atthe University of Montreal, Canada, November 2008.

Beaty, Jim. Orthopaedic On Call Crisis in the U.S. Visiting Professor, Presented at theUniversity of Montreal, Canada, November 2008.

Beaty, Jim. AAOS Update. Presented to the British Orthopaedic Association,Sept. 16-25, 2008.

Beaty, Jim. Fractures in Children – Update of Techniques and Procedures. Presented to the South African Orthopaedic Association, Cape Town, South Africa, Sept. 1-5, 2008.

Beaty, Jim. American Academy of Orthopaedic Surgeons 2008 and Beyond. Presented at the American Bone and Joint Surgeons Meeting, Jackson Hole, Wyo., June 2008.

Beaty, Jim. Emergency Call issues. Presented at the AOA Symposium: Current PediatricOrthopaedic Issues – A Small Window into Global Orthopaedic Issues, June 11 2009.

Beaty, Jim. The Future of Orthopaedics. Presented at the Japanese OrthopaedicAssociation Meeting, Sapporo, Japan, May 2008.

Beaty, Jim. Elbow Fractures in Children. Visiting Professor, Presented at the MedicalCollege of South Carolina, Charleston, S.C., April 24-27, 2008.

Beaty, Jim. Fractures of the Hip and Femur. Visiting Professor, Presented at the MedicalCollege of South Carolina, Charleston, S.C., April 24-27, 2008.

Beaty, Jim. AAOS update 2008. Visiting Professor, Presented at the Medical College ofSouth Carolina, Charleston, S.C., April 24-27, 2008.

Beaty, Jim. President’s Address – American Academy of Orthopaedic Surgeons. Presented at the The Atlanta Orthopaedic Society, Atlanta, Ga., October 2007.

Beaty, Jim. Fractures about the Elbow in Children 2007 – Treatment and Complications – What’s Really New. Presented at Emory University, Atlanta, Ga., October 2007.

Beaty, Jim. President’s Address – American Academy of Orthopaedic Surgeons.Presented to the Scoliosis Research Society, Edinburgh, Scotland, September 2007.

Beaty, Jim. Selection and Election of Leaders in Orthopaedics – Who and How?Presented at the Twentieth Century Orthopaedic Association Meeting, Brainerd, Minn., Aug. 15-18, 2007.

Beaty, Jim. American Academy of Orthopaedic Surgeons, 2007. Presented at theTwentieth Century Orthopaedic Association Meeting, Brainerd, Minn., Aug. 15-18, 2007.

Beaty, Jim. Update – American Academy of Orthopaedic Surgeons. Presented at theChicago Trauma Symposium, Chicago, Ill., August 10, 2007.

Beaty, Jim. Complications in Slipped Capital Femoral Epiphysis. Presented at theInternational Pediatric Orthopaedic Symposium, Orlando, Fla.

Beaty, Jim. Orthopaedics On Call – Issues and Solutions. Presented at the AmericanOrthopaedic Association Meeting, Asheville, N.C., June 2007.

Beaty, Jim. Surgical Management of Femoral Shaft Fractures in Children and Adolescents. Presented at the University of Texas, San Antonio, Texas, June 2007.

Beaty, Jim. Complications of Elbow Fractures in Children and Adolescents. Presented at the University of Texas, San Antonio, Texas, June 2007.

Beaty, Jim. Zebras and Horses - Pediatric Fractures of the Hip and Femur. Presented at the University of Texas, San Antonio, Texas, June 2007.

Beaty, Jim. President’s Update – American Academy of Orthopaedic Surgeons. Presented at the University of Texas, San Antonio, Texas, June 2007.

Beaty, Jim. American Academy of Orthopaedic Surgeons. Presented at the NationalAssociation of Orthopaedic Nurses, St. Louis, Mo., May 2007.

Beaty, Jim. Presidents Update American Academy of Orthopaedic Surgeons. Presented a the National Orthopaedic Leadership Conference, Washington, DC, May 2007.

Beaty, Jim. Neurovascular Injury with Supracondylar Humeral Fractures. Presented at the Pediatric Orthopaedic Society Meeting, Fort Lauderdale, Fla., May 2007.

Beaty, Jim. Fractures about the Elbow in Children. Presented at the University ofWisconsin, Wis., April 26-28, 2007.

Beaty, Jim. Orthopaedic Trauma On-Call. Controversy and Complexity. Presented at the University of Wisconsin, Wis., April 26-28, 2007.

Beaty, Jim. Surgical Management of Femoral Shaft Fractures in Children. Presented at the University of Wisconsin, Wis., April 26-28, 2007.

Beaty, Jim. Classics in Orthopaedics – Elbow Fracturesin Children. Presented at the Mid-America OrthopaedicAssociation Meeting, Palm Beach, Fla., April 11-14, 2007.

Beaty, Jim. American Academy of Orthopaedic SurgeonsUpdate State Society Presidents. Presented at the Mid-America Orthopaedic Association Meeting, Palm Beach, Fla., April 11-14, 2007.

Beaty, Jim. Supracondylar Fractures of the Humerus in Children – Treatment and Complications, What’s Really New? Presented at the American Academy of Orthopaedic Surgeons, San Diego, Calif., February 2007.

Beaty, Jim. Femoral Shaft Fractures in Children and Adolescents. Presented at the American Academy of Orthopaedic Surgeons, San Diego, Calif., February 2007.

Beaty, Jim. Femur Fractures in Children and Adolescents. Presented at the ArgentinaAssociation of Orthopaedics and Traumatology, Argentina, Dec. 3-6, 2006.

Beaty, Jim. Fractures about the Knee in Children and Adolescents. Presented at theArgentina Association of Orthopaedics and Traumatology, Argentina, Dec. 3-6, 2006.

Beaty, Jim. The American Academy of Orthopaedic Surgeons. Presented at the Argentina Association of Orthopaedics and Traumatology, Argentina, Dec. 3-6, 2006.

Beaty, Jim. Elbow Fractures – Treatment and Complications. Presented at the Argentina Association of Orthopaedics and Traumatology, Argentina, Dec. 3-6, 2006.

Beaty, Jim. Hip Fractures in Children and Adolescents. Presented at the ArgentinaAssociation of Orthopaedics and Traumatology, Argentina, Dec. 3-6, 2006.

William Warner, MD

Warner, William. Medial epicondyle fracture. Presented at POSNA annual meeting.Waikola Hawaii, 2010.

Warner, William. MRSA update. Presented at POSNA annual meeting. Albuquerque,N.M., 2008.

Warner, William. Pediatric Hip. Orthopedic review course. Presented at AAOS annualmeeting, 2007.

Warner, William. Instructional course lecture. Pediatric infection update. Presented atAAOS, 2007.

Warner, William. Predicting the outcome of distal femoral epiphyseal fractures.Presented at POSNA, San Diego, Calif., 2006.

Warner, William. Changing patterns of acute hematogenous osteomyelitis and septicarthritis: emergence of community acquired Methicillin resistance. Presented at American Academy of Orthopaedic Surgeons. Chicago, Ill., 2006.

Warner, William. Predicting the outcome of distal femoral epiphpyseal fractures.Presented at American Academy of Orthopaedic Surgeons. Chicago, Ill., 2006.

Warner, William. Changing patterns of acute hematogenouse ostepmyelitis and septicarthritis: emergence of community acquired Methicillin resistance. Presented at MidAmerica. San Antonio, Texas, 2006.

Warner, William. OLC course, Trauma. Presented at POSNA, Chicago, Ill., 2006.

Warner, William. Office Orthopedics, congenital knee dislocation ad raduigraphicevaluation of musculosketal infections. Presented at IPOS, Orlando, Fla.. 2006.

Warner, William. Instructional course lecture. Back pain. Presented at AAOS, 2006.

Jeffrey R. Sawyer, MD

Sawyer JR, Kelly DM, Warner Jr, WC, Guevara BG, Thompson NB. (2011) High Prevalence of Associated Injuries in Children with Spinal Fractures. American Academy of Othopaedic Surgeons.

Sawyer JR, Beaty JH. (2011) Staying Out of Trouble in Pediatric Orthopaedics. American Academy of Orthopaedic Surgeons.

Sawyer JR, Kelly DM, Warner Jr, WC, Beaty JH, Canale ST (2011) The Kickstand Technique to Promote Elevation and Wound Care in Pediatric Lower Extremity Injuries. American Academy of Orthopaedic Surgeons.

Sawyer JR, Guevara B, Thompson N, Dawkins R, Kelly DM, Warner Jr, WC. (2011) HighPrevalence of Associated Injuries in Children with Spinal Fractures. American Academy of Orthopaedic Surgeons.

Sawyer JR, Beebe M, Thompson N, Creek A, Kelly DM, Warner Jr, WC, Beaty JH. (2011)“Age-Related Patterns of Spine Injuries Following ATV Accidents in Children”. American Academy of Orthopaedic Surgeons

Sawyer JR, Warner Jr, WC, Kelly DM, Rachel JN, Williams JB. (2011) Is RadiographicEvaluation Necessary in Children with a Clinical Diagnosis of Calcaneal Apophysitis(Sever Disease)? American Academy of Orthopaedic Surgeons.

Sawyer JR, Bernard M, Kelly DM, Warner Jr, WC, Beaty JH. (2010) “Trends in Spine Injury Caused by All-Terrain Vehicle Accidents”. Orthopaedic Trauma Association.

Sawyer JR, Ivie C, Shroeder J, Beaty JH, Kelly DM, Warner Jr, WC, Canale ST, Huff A.(2009) Unplanned Return to the Emergency Room Following Treatment in a BusyFracture Clinic. Orthopaedic Trauma Association.

Sawyer JR, Bernard M, Kelly DM, Warner Jr, WC, Beaty JH. (2010) “Trends in Spine Injury Caused by All-Terrain Vehicle Accidents”. American Academy of Orthopaedic Surgeons.

Sawyer J, Pershad J, Williams S, Wan J. (2010) “Closed Manipulation and CastImmobilization of Distal Radius Fractures by Pediatric Emergency Room Physicians.American Academy of Orthopaedic Surgeons.

Sawyer JR, Rhodes L, Beaty JH, Canale ST, Kelly DM, Warner Jr, WC. (2010) Diagnosis and Treatment of Perthes Disease. American Academy of Orthopaedics – NationalAssociation of Orthopaedic Nurses Section.

Sawyer JR, Bernard M, Kelly DM, Warner Jr, WC, Beaty JH: (2010) “Trends in Spine Injury Cause by All-Terrain Vehicle Accidents”. Pediatric Orthopaedic Society of North America.

Sawyer J, Pershad J, Williams S, Wan J, (2010) “Closed Manipulation and CastImmobilization of Distal Radius Fractures by Pediatric Emergency Room Physicians.Pediatric Orthopaedic Society of North America.

Sawyer JR, Beebe M, Thompson N, Creek A, Kelly DM, Warner Jr, WC, Beaty JH (2010)“Age-Related Patterns of Spine Injuries Following ATV Accidents in Children”. PediatricOrthopaedic Society of North America.

Sawyer JR, Rhodes LN, Kelly DM, Messman L, Warner Jr, WC, (2010) Pediatric FractureClinics: Current Status and Future Directions. Pediatric Orthopaedic Practitioners Society.

Sawyer JR, Rhodes L, Beaty JH, Canale ST, Kelly DK, Warner Jr, WC (2010) Classification, Diagnosis and Treatment of Perthes Disease. Pediatric Orthopaedic Practitioners Society.

Sawyer JR, Smith JT, Wade J, D’Amato C, Campbell R, Vitale M (2010) Does Rib-BasedDistraction Control Curve Progression and Prevent Parasol Deformity of the Chest inScoliosis Associated with Congenital Myopathy? 4th International Congress onEarly Onset Scoliosis.

Sawyer JR, Conoley J, Beaty JH, Warner Jr, WC, Canale ST (2009) “Surgically Treated Tibial Tuberosity Fractures in Adolescents”. Pediatric Orthopaedic Society of North America.

Sawyer JR, Ivie C, Shroeder J, Beaty JH, Kelly DM, Warner Jr, WC, Canale ST, Huff A.(2009) Unplanned Return to the Emergency Room Following Treatment in a BusyFracture Clinic. Pediatric Orthopaedic Society of North America.

Sawyer JR, Rudloff M, Shroeder J, Gehrig, J (2009) “Are Fracture Patterns Sustainedby Children Involved in Motor Vehicle Accidents Affected by Age or Obesity?” PediatricOrthopaedic Society of North America.

Sawyer JR, Younas S, Benz CA, Warner Jr, WC, Kelly DM, (2009) “Factors InfluencingBlood Loss in Adolescent Idiopathic Scoliosis Patients Undergoing Posterior SpinalFusion with Instrumentation. International Meeting of Advanced Spinal Techniques.

Sawyer JR, Crenshaw WC, Younas S, Kelly DM, Warner Jr, WC, Muhlbauer MS (2009)“Characterization of Spine Injuries from a Regional Trauma Center” InternationalMeeting of Advanced Spinal Techniques.

Sawyer JR, Bernard M, Kelly DM, Warner Jr, WC, Beaty JH: (2009) “Trends in Spine Injury Caused by All-Terrain Vehicle Accidents 1997-2006”. International Meeting for Advanced Spinal Techniques.

Sawyer JR, Conoley J, Beaty JH, Warner Jr, WC, Canale ST (2009) “Surgically Treated Tibial Tuberosity Fractures in Adolescents”. Orthopaedic Trauma Association.

Sawyer JR, Mayfield ME, Warner Jr, WC, Beaty JH: (2008) “Long-Term Follow-up ofCongenital Hip Dislocations Treated with Open Reduction Through and AnteriorApproach”. Mid America Orthopaedic Society

Sawyer J, Pershad J, Williams S, Wan J, (2008) “Closed Manipulation and CastImmobilization of Distal Radius Fractures by Pediatric Emergency Room Physicians.Orthopaedic Trauma Association

Sawyer JR, Kapoor M, (2008) “Heterotopic Ossification of the Hip in a Child as a Result of Non-Accidental Injury: Report of a Rare Case. Southern Medical Association.

Sawyer JR, Rudloff M, Gehrig J (2008) “Injury Patterns in Children Involved in MotorVehicle Accidents: Role of Obesity”. American Academy of Pediatrics.

Sawyer JR, Hicks J, Beaty JH, Warner Jr. WC, Canale ST (2008) “The Hammerlock Position for Treatment of Medial Epicondyle Fractures”. Mid America Orthopaedic Society.

Sawyer JR, Kellum E, Creek A, Dawkins R: (2007) “Patterns of Injury in Children Injured in ATV accidents.” American Academy of Orthopaedic Surgeons.

Sawyer JR, Kellum E, Creek, A, Dawkins R,: (2007) “ATV Injuries in Children.” ClinicalOrthopaedic Society.

Sawyer JR, Kapoor M, Gilpin S: (2006) “Children at Risk Identified in an Urban Scoliosis School Screening Program: A Pilot Study.” Thirteenth International Meeting on Advanced Spine Techniques (Greece)

Sawyer JR, Kellum E, Creek A, Dawkins R: (2006) “Patterns of Injury in Children Injured in ATV accidents.” American Academy of Pediatrics.

Derek Kelly, MD

Katz, D. E., Herring, J. A., Browne, R.H., Kelly, D. M., & Birch, J. G. Brace TreatmentControls Progression in Adolsecent Idiopathic Scoliosis. Best Clinical Paper Award.Presented at POSNA, Waikoloa, Hawaii, 2010.

Herring, J. A., Sucato, D.J., Larson, A. N., DeLaRocha, A., Adolfsen, S., Kelly, D.M.,Martus, J.E., & Lovejoy, J.F. Prospective Multicenter Study of Legg-Calve- Perthes Disease: Functional and Radiographic Outcomes of Nonoperative Treatment in the Third Decade. Presented at POSNA, Waikoloa, Hawaii, 2010.

Sawyer, J. R., Beebe, M. J., Creek, A. T., Thompson, N., Yantis, M. G., Kelly, D. M., &Warner, W. C. Age-Related Patterns of Spine Injury Following All-Terrain Vehicle Accidents in Children and Adolsecents (E-Poster). Presented at POSNA, Waikoloa, Hawaii, 2010.

Kelly, Derek. Scoliosis. Presented at the National Meeting of the ASOPA/NAOT (American Society of Orthopedic Physician Assistants and National Association of Orthopedic Technicians). Memphis, Tenn., August 2009.

Kelly, D. M., McCullough, F. L., Kelly, H.R., & McCarthy, R.E. Long-term Outcomes ofAnterior Spinal Fusion with Instrumentation for Thoracolumbar and Lumbar Curves inAdolescent Idiopathic. Scoliosis Scoliosis. Presented to the Research Society, Edinburgh,Scotland, Sept. 8, 2007.

Kelly, D. M., McCullough, F. L., Kelly, H.R., & McCarthy, R.E. Long-term Outcomes ofAnterior Spinal Fusion with Instrumentation for Thoracolumbar and Lumbar Curves inAdolescent Idiopathic Scoliosis.” Presented at the Arkansas Orthopedic Forum. Little Rock, Ark., Oct. 27, 2006.

Le Bonheur Children’s and Campbell Clinic work closely so that children are afforded cutting-edge orthopaedic care with support from top technology, surgeons, therapists, etc. Campbell’s pediatric orthopaedists are:

James BeatyJames Beaty, MD, is a professor for the University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery and immediate former chief of staff for Campbell Clinic. He specializes in pediatric orthopaedics and pediatric trauma.

William WarnerWilliam Warner, MD, is a professor in the University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery. He also serves as division chief of Orthopaedics for St. Jude Children’s Research Hospital and is chief of Orthopaedics for Mississippi Crippled Children’s Services.

Jeffrey R. SawyerJeffrey R. Sawyer, MD, is director of the Pediatric Orthopaedic Fellowship program at the University of Tennessee-Campbell Clinic Department of Surgery, where he also serves as an assistant professor.

Derek KellyDerek Kelly, MD, is a clinical instructor at the University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery and serves as the primary physician for the Clubfoot Clinic at Le Bonheur Children’s.