Pediatric Orthopaedics

Overview
A young boy using a walker with two medical professionals behind him

For children with club foot, hip disorders, scoliosis, hand differences, limb deficiencies, spina bifida, cerebral palsy, sports injuries, and a host of other orthopaedic conditions, there is no place like Shriners Hospitals for Children – Northern California. Doctors provide care in the only free-standing children’s hospital in the Sacramento region. A statewide leader in pediatric orthopaedics, our Northern California Shriners Hospital is ranked by U.S. News & World Report as one of the top 50 pediatric orthopaedic programs in the nation.

Medical Concentration

Pediatric Orthopaedics

EOS Orthopaedic Imaging

Our EOS Imaging System (EOS) is helping us provide the highest quality care while reducing exposure to radiation for our patients. We are honored to bring orthopaedic patients this new technology and are grateful for the funding that was made entirely by donations.

Motion Analysis Lab

Patients benefit from the sophisticated technology found in the Motion Analysis Lab, one of only four of its kind in California, where a patient’s movement is measured with video documentation, 3-D motion analysis, and muscle-timing information.

Orthotics & Prosthetics

A regional leader in scoliosis and club foot bracing, the Pediatric Orthotic and Prosthetic Specialists (POPS) bring more than 175 years of combined experience designing braces, artificial arms and legs, and other adaptive devices for children. Occupational and physical therapists help children regain strength, skills, abilities and independence as they guide young patients on how to use adaptive devices and walk on their new legs. 

Shriners Hospital Upper Extremity Evaluation

This manual is intended to instruct on the correct administration of the Shriners Hospital Upper Extremity Evaluation (SHUEE). After reading through the Introduction, Test Administration, and Test Scoring and Interpretation sections, proceed to the Case Studies section to view example SHUEE videos. Blank scoring forms are provided under the Forms section for practice. Correct scores for each case study are provided with the videos. Click here to learn more.

The Medical Team

Michelle James, M.D.
Chief of Orthopaedic Surgery

Jon Davids, M.D.
Assistant Chief of Orthopaedic Surgery
Director, Motion Analysis Lab

Jennette Boakes, M.D.
Orthopaedic Surgeon

Loren Davidson, M.D.
Physical Medicine & Rehabilitation Specialist

Nicole A. Friel, M.D. 
Orthopaedic Surgeon, Sports Medicine Specialist

Brian Haus, M.D.
Pediatric Orthopaedic Surgeon
Sports Medicine Specialist

Fatema L. Iqbal, M.D. M.S.
Musculoskeletal Pediatrician

Vedant Kulkarni, M.D.
Orthopaedic Surgeon

Joel Lerman, M.D.
Orthopaedic Surgeon

Candice McDaniel, M.D.
Orthopaedic Surgeon

Craig McDonald, M.D.
Director, Spina Bifida Program

Debra Templeton, M.D.
Orthopaedic Surgeon

Melina McCahon, P.A.
Physician Assistant

Darvin Foo, PA-C, MMSc, PT
Physician Assistant

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Genetics study to probe mystery of cerebral palsy

News For You

Shriners Hospitals for Children has launched a 500-patient study to investigate how genetics might contribute to cerebral palsy, in collaboration with genetic researchers at the celebrated Jackson Laboratory.

This study has the potential to open up an entire new chapter on a disability once thought to be relatively well understood and straightforward, but that in recent years has become much more of an enigma.

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‘Guided-growth’ Supplanting External Bracing in Infantile Tibia Varus

News For You

Orthopedic surgeon Debra Templeton, M.D., used to prefer external bracing of the three alternatives for correcting early onset Blount’s disease but not anymore.

These days, when Dr. Templeton and the other surgeons at Shriners Hospitals for Children — Northern California have a child with early-onset Blount’s disease, they tend to perform a guided-growth procedure, with the tension plate screwed across the physeal disk of the tibia on the lateral side of the bowlegged knee or knees.

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EOS: Better X-Rays for Children

The Provider Post

Patients with scoliosis receive low-dose X-rays at the Northern California Shriners Hospital. Young patients liken the X-ray unit to a spaceship. Parents are often surprised at how quick and efficient it is – capturing AP and lateral view images at the same time.

EOS technology is something of a wonder.

The low-dose X-rays are of great reassurance to the patients and their parents, as patients with scoliosis generally get many, repeated X-rays during their lifetimes, and the exposures add up.

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Motion Analysis Center

Young Girl in the Motion Analysis Lab

The high-tech movement analysis conducted in this laboratory is integral to the complex, comprehensive care provided by Shriners Hospitals for Children – Northern California.

Doctor

Michelle A. James, M.D.

Chief of Orthopaedic Surgery & Pediatric Hand Surgeon

Michelle A. James, M.D.

Dr. James

Michelle A. James, M.D., is Chief of Orthopaedic Surgery at Shriners Hospitals for Children — Northern California and Chief of Pediatric Orthopaedics in the Department of Orthopaedic Surgery at the University of California Davis Health System.

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Doctor

Loren Davidson, M.D.

Physical Medicine and Rehabilitation Attending Physician

Dr. Davidson

Loren Davidson, M.D., is Medical Director for the Spinal Cord Injury program at Shriners Hospitals for Children – Northern California and Assistant Clinical Professor in the Department of Physical Medicine and Rehabilitation at the University of California Davis Health System.

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Doctor

Nicole A. Friel, M.D.

Sports Medicine Orthopaedic Surgeon

Nicole A. Friel, M.D., M.S. is an Orthopedic Surgeon and Sports Medicine Specialist with Shriners Hospitals for Children – Northern California.

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Doctor

Brian Haus, M.D.

Pediatric Orthopedic Surgeon and Co-Director of Pediatric Sports Medicine and Joint Preservation

Brian Haus, M.D.

Dr. Haus

Brian Haus, M.D., is a Pediatric Orthopedic Surgeon and Co-Director of Pediatric Sports Medicine and Joint Preservation at Shriners Hospital for Children, Northern California.

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Full Biography

Brian Haus, M.D., is a Pediatric Orthopedic Surgeon and Sports Medicine Specialist with Shriners Hospitals for Children — Northern California. Dr. Haus is a native of Sacramento and is dedicated to providing world-class care to children in his community.

Doctor

Fatema Lakhani Iqbal, M.D.

Musculoskeletal Pediatrician

Dr. Iqbal

Fatema Lakhani Iqbal, M.D., is the musculoskeletal pediatrician at Shriners Hospitals for Children — Northern California, where she is devoted to making a positive impact on the health and welfare of children through pediatrics and non-operative orthopaedics.

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Doctor

Yashar Javidan, M.D.

Pediatric Orthopedic Spine Surgeon

Yashar Javidan , M.D., is a Pediatric Orthopedic Spine Surgeon with Shriners Hospitals for Children – Northern California.  Dr. Javidan specializes in pediatric and adolescent spine surgery, with special expertise in reconstructive spine surgery for complex pediatric spinal deformities.

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Doctor

Vedant Kulkarni, M.D.

Orthopaedic Surgeon

Vedant Kulkarni, M.D., is a board-certified orthopaedic surgeon at Shriners Hospitals for Children – Northern California and a Clinical Assistant Professor at UC Davis School of Medicine.

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Doctor

Joel Lerman, M.D.

Orthopaedic Surgeon

Dr. Lerman

Joel Lerman, M.D., is an Orthopaedic Surgeon for Shriners Hospitals for Children – Northern California and Associate Professor in the Department of Orthopedic Surgery at the University of California, Davis, School of Medicine.

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Doctor

Holly Leshikar, M.D.

Orthopedic Surgeon

Dr. Leshikar

Holly Leshikar, M.D., is an orthopaedic surgeon at Shriners Hospitals for Children — Northern California and Assistant Professor at the University of California, Davis School of Medicine.

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Full Biography

Holly Leshikar, M.D., is an orthopaedic surgeon at Shriners Hospitals for Children — Northern California and Assistant Professor at the University of California, Davis School of Medicine.

Doctor

Craig McDonald, M.D.

Medical Director of the Spina Bifida Program

Dr. McDonald

Craig McDonald, M.D., is Medical Director of the Spina Bifida Program at Shriners Hospitals for Children – Northern California.

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Doctor

Candice O. McDaniel

Pediatric Orthopaedic Surgeon

Dr. McDaniel

Candice O. McDaniel, M.D., is a Pediatric Orthopaedic Surgeon with Shriners Hospital for Children – Northern California specializing in the treatment and care of children with skeletal trauma, clubfoot deformity, lower extremity sports injuries, and scoliosis.

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Article

Casts for Kids

A child getting a cast on their foot

Inside the clinic at Shriners Hospital, Matt Wilson and Brandon Neal cast 80 to 100 children each week.  Each child arrives with a special doctor’s order, and Matt and Brandon make sure they leave with a cast uniquely their own.

Clearly, each cast is a work of art. Pink casts, blue casts, arm casts, leg casts and casts with princesses and superheroes parade out of the cast room each day.

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Shoulder Spica Cast Care

What is the purpose of a shoulder spica cast?

A shoulder spica cast is used to stretch a tight shoulder after a botulinum toxin injection or to hold a child’s shoulder in position after tendon transfer surgery while the body heals.If your child is big enough, we will make the belly portion of the cast ahead of time while your child is standing up. After the fiberglass hardens, we will remove the belly band and then reapply it later in the operating room.

Two kids wearing casts sitting at a table

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Scoliosis

Diagram of Scholiosis

Scoliosis is a common condition that affects many children and adolescents. This condition of side-to-side spinal curves is called “scoliosis”. On an x-ray, the spine of a person with scoliosis looks more like an “S” or a “C” than a straight line. Sometimes parents note that their child’s shoulders or waist appear uneven. Some of these bones may also be rotated slightly, making one shoulder blade appear higher than the other.

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School Resources

Three images - Kids doing crafts, a girl looking through binoculars, and a kid on a climbing wall

The following resources are based on California State regulations for children attending publicly funded schools. If your child is attending school outside the state of California or a non-publicly funded school, some of these resources may be available. Check with your school, school district, and state programs.

This section refers to working with teachers. However, many of these resources can be used with coaches, tutors, babysitters, extracurricular activity instructors, camp directors, or anyone who will be working with your child.

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SCFE

Diagram of the hip joint

What Is Slipped Capital Femoral Epiphysis (SCFE)?

Slipped capital femoral epiphysis (SCFE; pronounced “skiffy”) is a hip condition when the top of the thighbone slips off the neck of the bone in a backwards direction. This causes pain, stiffness, and instability in the affected hip.

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Safety Promise

Cartoon image of people using a crosswalk

Joint and Bone Safety Matters

On the road to developing their adult bodies, children face many pathways of potential injury in their day-to-day activities. Simple safety practices provide the best strategies for insuring unintentional injuries to bones, joints and complex neuromusculoskeletal systems like the spine don’t interfere with childhood.

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Resources

Three picture - kids holding a VIP sign, Young girl playing table tennis, kid on a slip and slide

We encourage you to explore these additional resources which consists of organizations, camps, children’s literature, scientific literature, and media targeted to provide various supports and services for children with CHD. Some resources may be beneficial for your family while others are not applicable. This is not a comprehensive list and many other resources may be available. Beginning with this list will help connect you to further content that is applicable for your family.

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POSNA2018

POSNA Logo

Shriners Hospitals for Children – Northern California pediatric orthopaedic surgeon Vedant Kulkarni, M.D. has been invited as faculty to present at the 2018 meeting of the upcoming Pediatric Orthopaedic Society of North America (POSNA) in Austin, Texas.  The full course materials can be downloaded below.  We hope you find them beneficial and share them widely.

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Periacetabular Osteotomy

Diagram of Periacetabular Osteotomy

What is a Periacetabular Osteotomy?

Periacetabular Osteotomy, or P.A.O, is a surgical treatment for acetabular dysplasia that preserves and enhances your own hip joint rather than replacing it with an artificial part. The hip joint consists of two parts: the acetabulum (the socket), and the femoral head (the ball). The labrum is the lining of the acetabulum and acts like a cushion or seal to hold the joint together.

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Pediatric Hand Team

Three pictures - a doctor with two patients, two girls posing on a hike, and a man playing guitar

The Pediatric Hand Team is comprised of health care professionals who work together to provide the best care possible for your child and your family. This page introduces the health care professionals you may meet, describes their unique role, and provides example questions to help you speak to each professional’s area of expertise.

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Parent Experience

Three images of a family walking, a kid on a ropes course, and a family posing

If you are a new proud parent, congratulations on your new child! Your family will grow together in beautiful ways and we are here to support you on your journey.

This section of the website focuses on the more difficult themes and concepts, because these topics may require more support. The focus on hard topics does not mean that every parent will experience the challenges discussed here, some families may never experience them.

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EOS Orthopaedic Imaging

Shriners Hospitals for Children – Northern California is dedicated to providing the highest-quality patient care under the safest conditions. Our EOS Imaging System (EOS) is helping us provide the highest quality care while reducing exposure to radiation for our patients. We are honored to bring orthopaedic patients this new technology and are grateful for the funding that was made entirely by donations.

Young girl in an EOS imaging machine

EOS imaging system features and benefits:

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Congenital Hand Differences

Girl holding up an art project

Congenital Hand Differences (CHD) refers to all physical differences of one or both hands, arms or shoulders that are present at birth. Acquired hand differences are hand differences that are caused by injury or disease after birth. Children who acquire differences may have challenges similar to children with CHD. CHD is the term used on this website as it is most accessible for new parents and all limb differences will likely involve the difference of a hand.

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Child Experience

Three pictures of kids with congenital hand differences

Children with congenital hand differences (CHD) will live full and meaningful lives!! Younger children tend to consider the CHD a normal part of their body. Once they are old enough to understand they have a CHD, children are usually satisfied with the way their hand looks and works. They know that their hand difference is a part of them, but not all of them.

As they grow, children with CHD may experience challenges with some activities. This page focuses on some of these challenges and offers suggestions for navigating them.

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Cast Care

A little girl in a pink arm cast

Parents, please make every effort to keep your child’s cast clinic appointment. If you miss the appointment, and treatment is delayed, your child may have to wear the cast longer. If you are unable to keep an appointment, please notify the clinic to reschedule as soon as possible. 916-453-2180. Printable version of Cast Care instructions.

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Care of the Child in a Hip Spica Cast

Your child has had an operation or an injury and now needs a hip spica body cast. The hip spica cast is used to keep your child’s hips and legs from moving. This information will help you care for your child in the Spica Cast.

Parents, please make every effort to keep your child’s cast clinic appointment. If you miss the appointment, and the treatment is delayed, your child may have to wear the cast longer. If you are unable to keep and appointment, please notify the clinic to reschedule as soon as possible at 916-453-2180.

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Autologous Chondrocyte Implantation

Diagram of a Cartilage biopsy

What is Autologous Chondrocyte Implantation (ACI)?

Autologous chondrocyte implantation (ACI) is a two-stage state-of-the-art procedure used to treat isolated full-thickness (down to bone) articular cartilage defects. In short, a small piece of your articular cartilage is taken and sent to a special lab that grows your new cartilage cells over a 6 to 8 week period. When ready, these new cells are then transplanted to the injured area.

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Arthrogryposis

Arthrogryposis is a number of rare, nonprogressive muscle disorders causing stiff joints and abnormal development of muscles. From the Greek word meaning “curved joint,” children with arthrogryposis are born with a limited range of joint motion.

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Management of the Upper Extremity in Arthrogryposis

Management of the Upper Extremity in Arthrogryposis

Shriners Hospitals for Children — Northern California, a leading provider of pediatric orthopaedic care, invites occupational therapists, nurses, nurse practitioners, physician assistants and other health care professionals who assess and treat children with arthrogryposis to Arthrogryposis of the Upper Extremity. The seminar will take place at the Northern California Shriners Hospital, conveniently located just minutes from downtown Sacramento.

Pictures of four staff members

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Ankle Foot Orthosis

Follow these simple instruction to care for your child’s Ankle Foot Orthosis. Graduate your time of use with your new orthosis. In the beginning wear it for a short period of time and take it off, remove your sock and check for redness that you may not feel. Re-apply the orthosis and wear if for a longer time and inspect the skin again (unless otherwise directed by your physician or orthotist). Patient compliance is an integral part of the entire Orthotic protocol and must be adhered to in order to avoid potential problems and to maximize the effectiveness of the prescribed treatment.

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About Us

Three pictures of patients and kids at different events

This webpage is intended to serve as an accessible format to address parent concerns and anxieties when raising their children with CHD. The “We” used throughout the website refers to opinions and perspectives gained through research, clinical experiences, and lived experiences of Sarah and Michelle.

Two people at a desk looking at a computer

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SHUEE Test Scoring and Interpretation

Picture of a thumb in palm

Shriners Hospital Upper Extremity Evaluation (SHUEE) Test Scoring and Interpretation Scoring

The SHUEE data collection form consists of 2 pages. The first page is primarily descriptive and requires no scoring. The second page is utilized during the video taped portion and requires scoring of the Spontaneous Functional Analysis (SFA), the Dynamic Positional Analysis(DPA), and the Grasp/Release(GRA) segments on the actual SHUEE form. The SFA score is circled and the DPA score is marked in the grid with a check mark.

Article Camp Winning Hands 2020

Patients Explore Potential

Camps & Resources

Camp Winning Hands

Patients are encouraged to engage in therapeutic recreation and other activities that allow them to explore their full potential. Recreation specialists organize patient outings that include ski trips, sporting events and movies. Patients with hand differences and their families are invited to participate in Camp Winning Hands.