Centers of Pediatric Orthopedic Excellence

Clubfoot is a deformity in which an infant's foot is turned inward. It’s usually so severe that the bottom of the foot faces sideways or even upward. It is one of the more common congenital (present at birth) foot deformities, according to the American Academy of Orthopedic Surgeons, and is often detected on prenatal ultrasounds before birth.

Clubfoot needs to be treated for children to walk properly. With proper treatment, children will live a normal, active life. Treatments include:

• Stretching
• Casting
• Bracing
• Surgery in some cases

Christina Hardesty, MD, is a nationally recognized specialist in clubfoot deformity diagnosis and treatment. She sees patients at MetroHealth Main Campus.

To make an appointment, call 216-778-4393.

Hip and limb deformities are common conditions that can be present at birth or develop as the child grows. Dr. Raymond Liu, MD, specializes in complex hip and limb deformities. Hip and limb deformities can cause early arthritis and other chronic complications later in life. Finding better treatment strategies for these deformities to help prevent problems later in life is one of Dr. Liu’s areas of focus in research. He has published more than 90 papers in peer-reviewed orthopedic journals and has given invited lectures nationally and internationally. Dr. Liu has also served as the President of the Limb Lengthening and Reconstruction Society and is Deputy Editor of Hip and Lower Extremity for the Journal of Pediatric Orthopaedics.

Hip Dysplasia

Developmental dysplasia of the hip (DDH) is a problem with the way a baby's hip joint forms. This condition can develop before or after the baby is born. It can affect both hips or just one side.

With treatment, most infants with DDH develop into active, healthy kids. The goal of care is to get the ball of the hip in the socket; this allows the joint form normally.

Raymond Liu, MD, is a nationally recognized specialist in deformities treatment. Treatment options are based on the child’s age and can include:

• bracing
• closed reduction and casting
• open reduction (surgery) and casting

Limb Deformity

Limb deformities can cause chronic pain and disability. Raymond Liu, MD, is a nationally recognized specialist in hip and limb deformity treatment. He offers limb lengthening treatments, guided growth, and other limb reconstruction procedures to help patients get better alignment and normal function.

MetroHealth treats:

• Angular knee deformity (Blount disease, genu valgum)
• Congenital limb deficiency (congenital femoral deficiency, fibula hemimelia, tibia hemimelia)
• Growth arrest
• Limb length discrepancy
• Osteogenesis imperfecta
• Rotational deformity (femoral anteversion, tibial torsion)
• Skeletal dysplasias

Mild limb deformities may be treated non-surgically, using techniques such as casting, splinting, braces, and shoe lifts.

Surgical options include limb-lengthening and limb-correcting surgery, which cuts into the bone and uses a device, either on the outside of the leg or an implant inside the leg, to slowly repair or lengthen the bone.

To make an appointment, call 216-778-4393.

MetroHealth’s pediatric orthopaedics team is equipped to diagnose and to treat neuromuscular disorders and spasticity. Our goal is to provide children with better mobility, more independence, and improved quality of life.

We treat:

• Cerebral palsy
• Muscular dystrophies, including
  • Duchenne
  • Becker
• Down syndrome
• Inherited neuropathies
• Spina bifida

Treatments include:

• Oral medications
• Physical therapy
• Injectable medications, such as botulinum toxin
• A pump placed in the abdomen wall to administer medication (intrathecal baclofen)
• Surgery to correct deformities or improve function

Christina Hardesty, MD, is a nationally recognized specialist in neuromuscular disorders and spasticity diagnosis and treatment. She sees patients at MetroHealth Main Campus.

To make an appointment, call 216-778-4393.

MetroHealth’s pediatric orthopaedics team provides cutting-edge, nationally recognized care for a range of pediatric spine conditions. We treat:

• Scoliosis (idiopathic, congenital, neuromuscular, and early onset scoliosis)
• Spondylolysis and spondylolisthesis
• Kyphosis
• Back pain
• Spinal injuries
• Spinal tumors

Our team offers a range of non-operative and surgical options to treat spinal deformities. Jonathan Belding, MD, and R. Justin Mistovich, MD, have pioneered a world-class, cutting-edge two-surgeon approach for kids with spinal deformities. By having two experienced surgeons consistently work together, Drs. Belding and Mistovich’s technique has many advantages compared to a single surgeon approach, such as: shorter surgeries with less time in the operating room, less blood loss during surgery, and shorter hospital stays—all while achieving better curve correction.

Learn more about their unique, two-surgeon approach.

Additionally, they have presented their work nationally and internationally on decreasing the incidence of surgical site infections and improving outcomes after surgery.

Dr. Belding sees patients at MetroHealth Main Campus, Lyndhurst Health Center, and Parma Medical Center.

Dr. Mistovich sees patients at MetroHealth Main Campus and Cleveland Heights Medical Center.

To make an appointment, call 216-778-4393.

Pediatric and adolescent sports injuries, such as ACL tears, meniscus tears, and kneecap or shoulder dislocations are common among young athletes. With prompt diagnosis and an individualized treatment plan, our team can get your child back in the game. We treat:

• Athletic injuries to the ankle, knee, elbow, shoulder, and wrist
• Anterior cruciate ligament (ACL) tears in growing athletes
• Damaged cartilage and cartilage preservation surgery
• Joint instability including medial patellofemoral ligament (MPFL) tears
• Shoulder dislocations and labral tears
• Meniscus tears
• Osteochondritis dissecans (OCD) lesions
• Treatment for sprains, strains, and bone fractures
• Surgical intervention for traumatic injuries

R. Justin Mistovich, MD, is a nationally recognized leader in pediatric sports medicine. He serves as a Director for the Pediatric Research in Sports Medicine Society.

Dr. Mistovich recognizes the importance of prompt diagnosis and early treatment for injured athletes: he led a multi-center study that found delaying surgery for young athletes with anterior cruciate ligament (ACL) tears can cause further damage to the patient’s knee joint. The study evaluated 546 cases of ACL tears in young athletes and whether each patient developed further complications (a medial meniscus tear) after the initial ACL injury. They found that the longer a reconstructive surgery is delayed, the higher the risk of additional injury.

MetroHealth’s pediatric orthopaedics team can see patients quickly – sometimes on the same day. Dr. Mistovich sees patients at MetroHealth Main Campus and Cleveland Heights Medical Center.

To make an appointment, call 216-778-4393.

Orthopaedic Surgery

MetroHealth’s board-certified orthopaedic surgeons are leading experts at bone, muscle and joint repair. Our specialists provide unsurpassed care for adults and children with minor to severe trauma, chronic degenerative disorders and congenital or developmental conditions.

We are an academic health center, where our board-certified surgeons have advanced fellowship training in their areas of expertise.

Conditions We Treat

As a Level I Adult Trauma Center and Level II Pediatric Trauma Center, we treat patients with severe, complicated injuries. Our orthopaedic team has the expertise to repair the most exceedingly difficult fractures. We are specialists in complex pediatric and adolescent fracture and injury management including subspecialty care for complex hand and upper extremity injuries.

Surgical Services We Offer

• Arthroscopy
• Complex joint fracture repair
• Open fracture repair
• Osteotomy
• Pelvic and acetabular (hip socket) fracture repair
• Reattachment of amputated hands and fingers
• Repair of fractures that didn’t heal well
• Repair of unstable joints after injury

Pediatric Trauma and Reconstruction Center

Our team includes three pediatric orthopaedic surgeons who specialize in complete musculoskeletal care for children and adolescents. They are experts in diagnosing and treating the various kinds of injuries common to children.

Our pediatric orthopaedic surgeons also treat congenital and developmental deformities such as clubfeet, hip dysplasia, in-toeing and out-toeing, bowed legs, slipped capital femoral epiphysis (a hip disorder seen in adolescents) and Blount’s disease.

To make an appointment, call 216-778-4393.