The MRI results showed bleeding on Richy’s brain, known as a Duret hemorrhage, a condition that is almost always fatal, usually only discovered in autopsies.

Richy’s condition was the result of multiple (five, to be exact) concussions throughout his four-year football career. A concussion is a traumatic brain injury that alters the way a person’s brain functions. Symptoms are usually temporary and include dizziness, confusion, headaches and nausea. But concussions are especially dangerous because they often go unreported because the symptoms are synonymous with helmet-to-helmet collisions between 200+ pound bodies – of course their heads will hurt.

It’s a lot more serious than that though.

The risk of concussion is greatest in football and rugby, followed by hockey and soccer, and that the risk of concussion for young women and girls was greatest in soccer and basketball, and the need for awareness has stretched across the country as more than a million American athletes experience concussions each year, and many more go unreported.

Hilgers, along with his new colleagues at Level One Orthopedics, hopes to raise awareness about the dangers of concussions by teaching them about prevention, and symptoms that they absolutely can’t ignore.

“He could have died from this concussion,” Hilgers said. “There are not many cases like Richy’s. He’s a very lucky case.”

Generally, injuries from running include things like runner’s knee, plantar fasciitis and shin splints, and occur from overuse, lack of stretching or warming up, poor technique or running in shoes that don’t provide sufficient support for your body type or running style. In her latest article published on According to Winnie, Dr. Davis provides information about how to recognize these injuries as well as how to treat and prevent them from happening again.

The Orlando Sentinel published an article today on the increased risk of sports injuries and orthopedic emergencies to cheerleaders. It includes comments from Dr. Elizabeth Davis, sports medicine specialist at Arnold Palmer Hospital for Children.

Read the Full Article

Our hospitals do utilize other products from NECC, and out of an abundance of caution, we immediately sequestered those products under guidance from the FDA. We are compiling a list of patients who received those products during treatment at any Orlando Health hospitals. All those patients and their physicians will receive notification from Orlando Health.

We will continue to monitor this situation to ensure the health and safety of our patients.

What is clubfoot?

Clubfoot is a deformity that most of the time can be identified on prenatal ultrasound but is certainly present at birth. It is a foot deformity where the foot has an extremely high arch, the sole of the foot is turned in and the toes are pointed down like a ballerina. In other words, when the baby is resting the foot is turned to point into the diaper and not in a normal position. Idiopathic means that there is no identifiable cause for the clubfoot to occur whereas non-idiopathic means that the clubfoot is associated with some known reason, either genetic or a syndrome such as arthrogryposis.

What kind of stimulus spurs this abnormality? (Genetic, medication, alcohol, etc?)

Idiopathic types have no identifiable cause; low volume of amniotic fluid (oligohydramnios) can sometimes be associated with this.

Non-idiopathic clubfoot is also called syndromic, it can be genetically carried, or associated with a disorder such as arthrogryposis, which presents in a variety of severity, as well as other syndromes.

How common is clubfoot? How common is the bilateral version?

The rate of children born with clubfoot varies across ethnicities; the highest rate known is the Maoris, the indigenous population of New Zealand, at a rate of 7 per 1,000 live births. The United States has a rate of 1.5 per 1,000 live births. In perspective, Winnie Palmer Hospital for Women and Babies (one of the busiest birthing centers in the US) has close to 15,000 births a year, coming out to approximately 22 babies born with clubfoot each year. The rate of single or bilateral clubfoot varies as well, however about 30-40 percent at our center are born with clubfoot on both sides.

 What is life like for a child with untreated clubfoot? What would life be like in mild cases? In extreme cases?

Life with untreated clubfoot is difficult; children with it can walk and maybe run but do so by walking on the tops of their feet not the sole. This eventually leads to pain and sometimes to use of a wheelchair. While very mild clubfoot may result in more normal function, true clubfoot requires treatment in order for 97-98 percent of non-idiopathic clubfeet to function normally.

How long has the Ponseti Method been around?

Dr Ponseti developed his casting method around 65 years ago and should only be called the Ponseti clubfoot casting method. Other methods are not nearly as effective of producing long lasting success with no or minimal surgery.

Is it the most popular/successful method to date? What are the alternative treatments?

The Ponseti technique is by far the most successful treatment regimen in the world for treatment of clubfoot. Other methods are either surgical in nature or require fall back onto significant surgical treatment over 50-60 percent and up to 90 percent of the time. There is one treatment called the French method which is a daily intensive physiotherapy method that takes place at a physical therapy center, but this has a higher invasive surgical rate than the Ponseti method.

Walk me through the steps or phases of this treatment.

The treatment is a gentle manipulation of the foot on a weekly basis that is then held in position with a long leg plaster cast. The foot is corrected in a gradual fashion and each week improvement is seen. While the baby may be fussy during the gentle manipulation process, the method is not painful. We do not want pain at all, we want to stretch the tight tissues, not tear them to get them into position as tearing causes both pain and inflammation which can cause scarring and slow down the correction process. The average number of casts or weeks of new casts placed is 5-7 once the treatment is started. In some non-idiopathic conditions it can take 10-12 casts or more. Once the high arch and the foot turn in is completely corrected, almost all idiopathic or non-idiopathic clubfeet will require a procedure to release the heel cord immediately prior to the last cast being placed. At Arnold Palmer Hospital for Children this is usually done in clinic, painlessly with the use of numbing cream. No general anesthesia is required for these babies unless they are too old and strong to keep still, in which case they might need to have general anesthesia. If a release of the heel cord is required, the last cast stays on for 3 weeks for the released heel cord to completely heal.

After active casting is over, the child wears a maintenance of correction device that comes in three forms, Dennis-Browne bar and shoes, Ponseti AFOs, or the Dobbs bar and AFOs. This is worn 22 hours for 2-3 months. After this it is worn during the night and nap time until the child is five years old. With this treatment, by the time the child is crawling age they are only wearing the maintenance device at night and during naps.

With the maintenance device worn as prescribed, the clubfoot is for all intensive purposes normal for the rest of their life, with long term studies showing that the well-corrected clubfoot with the Ponseti method has no more risk of having foot pain than people born without a foot deformity. 85 percent of those wearing the maintenance device as prescribed will never require more casting or other treatment, but when not worn correctly only 30 percent will avoid more casting or surgery. Most clubfoot recurrences can be treated with casting alone even in children under ten.

How has the Ponseti Method changed the prognosis for children born with this condition?

The Ponseti technique has allowed not only an option, but the best option for treatment of children born with clubfoot. Properly performed, the Ponseti method is the best chance of a normal life (from a foot standpoint) for a child born with clubfoot.

One example is heel pain in growing gymnasts. A growth plate injury from a combination of tightness of the Achilles tendon and unrelenting training/pounding of the growth plate, is called Sever’s disease. It is characterized by pain at the insertion site of the Achilles tendon onto the heel bone (calcaneus). It can be so severe that it acts like a true fracture of the heel bone, cause inability to participate in gymnastics or even walk without severe pain. It can be treated with, stretching/strengthening  of the Achilles tendon, icing, anti-inflammatories on a regular basis, and cushioning of the heel bone with silicone type of heel cushions at least 1cm thick. If this allows the athlete to compete at their expected level with only mild discomfort than nothing more is required. Typically this disappears as the growth plate does as well. If the pain keeps the athlete from competition despite this treatment than more aggressive treatment is warranted, sometimes even casting. Casting can expidite the healing process and allow any athlete to return quicker with potentially less likelihood of recurrence.

A second more serious example of overuse injuries in gymnastics is called Osteochondritis dissecans or OCD. This can happen in any joint but frequently occurs in the elbow of gymnasts. From overuse and repetitive weight-bearing on a joint that is susceptible to injury, a fracture of sorts develops in the elbow that results in loss of support for the joint surface. This can eventually lead to what you an think of as a pot hole of the joint surface where the broken bone and joint surface attached to it falls out of place into the joint. If this happens surgery is necessary to try to fix the elbow surface. Occasionally this leads to the gymnast retiring from gymnastics. Dr. Jay Albright recommends that any gymnast with elbow pain, seeks advice from a sports trained physician specializing in the growing athlete like we have at Level One Orthopedics to evaluate if their pain is a result of this type of injury. If caught before a pot hole forms and is properly treated, most of the time surgery can be avoided.

Find out how Dr. Jay Albright and Level One Orthopedics helped a local gymnast overcome an elbow injury.

Larry the Cable Guy, Orlando Health Open Hip and Orthopedic Institute

Comedian’s $5 Million Gift Funds Development of Institute

 Orlando, FL (May 1, 2012) – Larry the Cable Guy, whose real name is Dan Whitney, was on hand at Orlando Health to open the Wyatt Whitney Hip & Orthopedic Institute.

The Wyatt Whitney Institute, which is named after the comedian’s five-year-old son, houses a number of specialists and resources dedicated to the treatment of hip and orthopedic conditions. It will emphasize collaboration between physicians and their teams to provide patients seamless, comprehensive orthopedic care from infancy through adulthood. Patients at the institute will have access to advanced pediatric and adult orthopedic services, sports medicine, physical rehabilitation services, and state-of-the-art imaging, along with research and educational resources to enhance their experience.

Development of the Wyatt Whitney Institute is possible because of the generosity of Larry the Cable Guy. Nearly two years ago, he and his family donated $5 million through the Git-R-Done Foundation to help fund development of the institute.

“We’re very appreciative of the generosity and optimism the Whitneys have shown in turning their son’s experience with hip dysplasia into an opportunity to help others,” states John Bozard, president of Arnold Palmer Medical Center and the Orlando Health Foundation. “Their gift will go a long way towards ensuring that we have the capability to help others do things like walk or run without pain or discomfort.”

Wyatt Whitney was born with hip dysplasia, meaning that the bones of the hip joint are not aligned correctly. It’s a condition that affects thousands of children and adults each year, and when it was first discovered in Wyatt, very little information about hip dysplasia was available anywhere.

That’s when the Whitneys began their search for answers and found Charles Price, MD, of the department of pediatric orthopedics at Arnold Palmer Hospital for Children and one of the world’s leading experts in hip dysplasia.

With help from Dr. Price, Wyatt successfully completed treatment for his hip dysplasia. The gift from the Whitneys allowed Price to work with other hip dysplasia experts around the world to develop the International Hip Dysplasia Institute (IHDI) as a source of information and guidance to families affected by the condition. IHDI also serves as a resource for medical professionals worldwide. It includes leading orthopedists working to develop better methods of detection, prevention and treatment of hip dysplasia.

In addition to housing IHDI, the Wyatt Whitney Institute is home to Level One Orthopedics, Orlando’s premier academic orthopedic center, where world-class orthopedic surgeons will continue their tradition of exemplary patient care, research, and education of the next generation of orthopedic surgeons.

“When we learned Wyatt had hip dysplasia as a baby, it was very difficult to find any good sources of information on his condition and it frustrated us that so little was being done to help kids like him,” stated Larry. “We were fortunate to find Dr. Price and get Wyatt the treatment he needed. It also created an opportunity for my wife and me to make a real difference in the lives of other people.”

Larry and the Git-R-Done Foundation continue to support Orlando Health with the annual “Git-R-Done Celebrity Golf Classic” held in Orlando.  The two-day golf event features Larry and his celebrity friends raising money for The International Hip Dysplasia Institute.  This year’s event is scheduled for November 4-5.

To arrange an appointment at the Wyatt Whitney Institute, patients should call 321-843-DOCS. 

About the Git R Done Foundation

The Git-R-Done Foundation is a 501(c) (3) non-profit organization established by Larry the Cable Guy and his wife, Cara, as a focal point for the family’s philanthropy in 2009.  The foundation’s mission is to provide assistance to charitable organizations that have experienced hardships beyond their control, with an emphasis on children and veterans.  The Git-R-Done Foundation has made numerous donations, including donations to the Arnold Palmer Medical Center Foundation for the treatment and cure of hip dysplasia, Madonna Rehabilitation Hospital and Operation Homefront.  For information or to donate, visit www.gitrdonefoundation.org

About the International Hip Dysplasia Institute

The International Hip Dysplasia Institute (IHDI) is a collaborative, international, not-for-profit effort to improve the health and quality of life of those affected by hip dysplasia. Arnold Palmer Medical Center is leading several academic medical centers around the world to promote prevention, diagnosis, treatment, and research for hip dysplasia. Another goal is to provide education to patients, families, and physicians as the most comprehensive and reliable resource for knowledge about hip dysplasia in its various forms. This international collaborative effort was made possible by a generous gift from Larry the Cable Guy and his family.

About Orlando Health

Orlando Health is a $1.9 billion not-for-profit health care organization and a community-based network of hospitals and care centers throughout Central Florida. The organization, which includes the area’s only Level One Trauma Centers for adults and pediatrics, is a statutory teaching hospital system that offers both specialty and community hospitals.  They are: Orlando Regional Medical Center; Arnold Palmer Hospital for Children; Winnie Palmer Hospital for Women & Babies; Dr. P. Phillips Hospital; South Seminole Hospital; Health Central Hospital, South Lake Hospital (50 percent affiliation); St. Cloud Regional Medical Center (20 percent affiliation) and MD Anderson Cancer Center Orlando – the first affiliate of one of the nation’s premier cancer centers, The University of Texas MD Anderson Cancer Center in Houston.  Orlando Health’s areas of clinical excellence are heart and vascular, cancer care, neurosciences, surgery, pediatric orthopedics and sports medicine, neonatology, and obstetrics and gynecology.

Orlando Health is one of Central Florida’s largest employers with nearly 16,000 employees and more than 2,500 affiliated physicians supporting our philosophy of providing high quality care and service that revolves around patients’ needs.  We prove this everyday with over 110,000 inpatient admissions and nearly 690,000 outpatient visits each year.   In all, Orlando Health serves 1.6 million Central Florida residents and nearly 3,000 international patients annually.  Additionally, Orlando Health provides approximately $239 million in support of community health needs.  More information can be found at www.orlandohealth.com.

ORMC joins Johns Hopkins and others in federally-funded trauma research

ORLANDO, Fla. (January 21, 2011) — Orlando Regional Medical Center (ORMC) is one of two dozen major trauma centers recruited to participate in a series of national studies focused on the treatment and outcomes of major orthopedic injuries to military service members. The hospitals are part of the Major Extremity Trauma Research Consortium (METRC) formed in response to high number of service members who are injured. The Consortium was recently awarded $38.6 million by the U.S. Department of Defense (DOD) to address the 82 percent of all service members in Operation Iraqi Freedom and Operation Enduring Freedom who sustain significant extremity trauma – many with injuries to multiple limbs.

The network of core civilian trauma centers will work together with the major military medical centers that provide definitive treatment to the service members who sustain major trauma while on active duty.  The overall goal of the Consortium is to produce the evidence needed to establish treatment guidelines for the optimal care of the wounded warrior and ultimately improve the clinical, functional and quality of life outcomes of both service members and civilians who sustain high energy trauma to the extremities.

“One of only a few centers, Orlando Regional Medical Center has a unique opportunity to share expertise with an elite group of trauma centers across the country through multiple studies, helping improve patient care,” said George J. Haidukewych, MD, chief of orthopedic trauma and academic chairman and program director, Orthopedic Surgery at Orlando Health.

As Greater Orlando’s only Level One Trauma Center, ORMC treated more than 4,100 patients last year with complex injuries from high energy events including ejection from vehicles, significant falls, vehicle-pedestrian impact, firearm wounds and other traumatic injuries – making the hospital an important contributor to the consortium.

One of the studies ORMC will participate in evaluates the effectiveness of internal and external fixation for severe lower leg extremities. Comparing treatments – internal or external fixation – will lead to better patient outcomes for military members and civilians. The most common types of internal fixation include pins, rods, screws and plates used inside the body to support the bone directly. Pins, rods and screws are also used to make external fixators, like frames and rings, but outside the body, going through the skin and muscle to connect to the bone.

“A study of this magnitude requires multiple centers to answer the difficult question of whether or not internal or external fixation is a better treatment option for patients,” said Joshua R. Langford, MD, principal investigator and orthopedic traumatologist, Orlando Health Orthopedic Faculty Practice. “Together we will address the most pressing issues in orthopedic trauma care.  The results of our studies will change practices, resulting in better care for all who are injured.”

While types of injuries and the environment for civilians may differ for soldiers, the principals for treatment are similar.

The recent award is in addition to the $18 million award by the DOD to establish the Consortium in September 2009 to address some of the immediate research needs of the military in the acute management of severe limb injuries.

Dr. Langford explains, when a soldier has a severe lower leg injury from an explosive device and a civilian has a severe lower injury from a motor vehicle crash, both are high energy events impacting the bone.

The Johns Hopkins Bloomberg School of Public Health serves as the coordinating center for the Consortium.

“We are thrilled to have ORMC as our partner in this effort to improve the standard of care for the wounded warrior and civilian trauma patient,” said Ellen MacKenzie PhD, Director of the Consortium’s Coordinating Center and the Fred and Julie Soper Professor and Chair of the Bloomberg School’s Department of Health Policy and Management. “Without a large multi-center effort such as this, we would be unable to effectively study many of the issues that are critical to ensuring the best outcomes following a severe injury.”

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About Orlando Health

Orlando Health is a $1.7 billion not-for-profit health care organization and a community-based network of hospitals and care centers in the Orlando region.  The organization, which includes the area’s only Level One Trauma Centers for adults and pediatrics, is a statutory teaching hospital system that offers both specialty and community hospitals.  They are: Orlando Regional Medical Center; Arnold Palmer Hospital for Children; Winnie Palmer Hospital for Women & Babies; Dr. P. Phillips Hospital; South Seminole Hospital; South Lake Hospital (50 percent partnership); St. Cloud Regional Medical Center (20 percent partnership) and MD Anderson Cancer Center Orlando – the first affiliate of one of the nation’s premier cancer centers The University of Texas M. D. Anderson Cancer Center in Houston.  Orlando Health’s areas of clinical excellence are heart and vascular, cancer care, neurosciences, surgery, pediatric orthopedics and sports medicine, neonatology, and obstetrics and gynecology.

Orlando Health is Central Florida’s fifth largest employer with nearly 14,000 employees and more than 2,000 affiliated physicians, all of whom support our philosophy of providing high quality care and service when it matters most.  We prove this everyday with over 100,000 inpatient admissions and more than 600,000 outpatient visits each year.   In all, Orlando Health serves 1.6 million Central Florida residents and nearly 3,000 international patients annually.  Additionally, Orlando Health provides approximately $198 million in support of community health needs.  More information can be found at orlandohealth.com.