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We immediately met with our local doctor that referred us to an orthopaedic consultant, the Professor advised that it will be risky to get treatment for her in our home country (Nigeria) as we might not have the required expertise and facilities for super hip procedure that will be required, he told us Dr Paley will be our best option for this treatment. With the Professor’s report, we engaged Dr Paley, and he gave us the big relief that with a couple of surgeries (one super hip and couple of limb lengthening) in her lifetime, our beloved daughter will be able to walk, run and play like other children.

In 2011, we got the cost of the super hip surgery estimated to be 119,267USD, this was massive cost due to the valuation of our local currency against the US dollars, this was about my six years gross annual income, i shared with Dr Paley how difficult it would be for us to raise the funding, he gave his word and i quote “I will make it happen” , few months later he reached out to me that he has been able to get a charity to support with the funding along with the little funds that we will able to raise, we became very excited as we believe this will start the treatment for our daughter but getting a US visa became a challenge despite the letters from Dr Paley to the embassy, after applying about three times over about 4 years, our hopes started dwindling.

Over this period, we kept our communication lines open with the Dr Paley and he kept responding and giving us the reassurance that it will happen, this communication kept our hopes alive, for this we thank Dr Paley as he did not give up on us.

In 2015, after several visa denials by the US embassy, I suggested that we could have the surgery done out of US as our daughter is growing by the day and the difference in the limbs kept on increasing, this Dr Paley equally agreed, we considered Isreal, this did not work out due to insecurity in the region.

Still we kept our communications lines open to Dr Paley, On June 15th, 2023, i got an email from Dr Paley that he has some funding that can support the surgery of our daughter and he has a centre in Abu Dhabi where he usually visits at intervals where the surgery will take place, that was like the best news i have received in my lifetime, for this i thank Dr Paley and we will eternally be grateful.

Then the visa challenge came up as issuance of visa to Nigerians was on hold by UAE, this seems like the best opportunity as our daughter who is 13 then was not getting any younger, we had to use all at our disposal to ensure that we get the visa. On 9th May we succeeded in getting the visa to catch up with the appointment with Dr Paley, scheduled visit of May 2025.

We started gathering ourselves by raising funds for the trip from savings, family, friends and loans to take care of the flight, feeding and accommodation in Abu Dhabi, this is enormous due to the conversions rates of our local currency to USD and AED, we must appreciate again Dr Paley for giving our daughter hope of better livelihood for supporting with the surgery and hospital cost.

We arrived in Dubai on 24th of May where we were received by a personnel of the hospital that drove us to the clinic in  Abu Dhabi, on arrival we were received warmly at the reception, i must confess, i have never seen any hospital as beautiful as Burjeel medical centre (BMC), every service is world class, friendly and prompt  pickup service from the hotel, excellent Dr Paley’s team, friendly Paley clinic staffs, very accommodating ICU personnel, nutritious food, good ward environment and nurses, physiotherapist is top notch, Advanced care team; willing to support, very beautiful overall ambience. 

I thank God for the successful super hip surgery of my daughter and specially appreciate everyone and teams that has supported us in this medical journey of our daughter, we are looking forward to our return for the limb lengthening surgeries that are expected to come up in the future, it will be an opportunity to reconnect with these great people and wonderful teams.

Thank you, Dr Paley and the entire team.

Thank you, BMC and the entire team.

Thank you, Advanced care and the entire team.

We will eternally be grateful for this support.

Upon a neurologist’s diagnosis of herniated discs, arthritis, and spinal cord compression and swelling in my 60-year-old neck, I was referred to an experienced and competent neurosurgeon. The surgeon informed me that an operation through the front of my neck, which would remove ruptured discs and hardened ligaments, was needed to relieve the severe compression of my spinal cord.

Soon thereafter I sought a second opinion from Dr. Scott Raffa at the Paley Institute’s Cantor Spine Center. Dr. Raffa explained to me that indeed surgery was warranted, and that an additional procedure, through the back of my neck, should also be done for the best possible outcome. This procedure would provide additional decompression of my spinal cord, by enlarging the spinal column with inserted bone grafts, and relieve chronic neck and shoulder pain by removing arthritic bone spurs.

To accomplish these treatment objectives, Dr. Raffa and his staff would utilize their extensive training and experience with the most modern, proven and effective tools and techniques. An example is the ultrasonic bone scalpel, which cuts through vibration, not sharpness, making it very safe and effective for use in surgeries adjacent to the spinal cord. Dr. Raffa told me that his intent was for this to be the first, and last, neck surgery I would ever need.

After a short period of deliberation, and consultation with my daughter who is a registered nurse with experience caring for cervical spine patients, I decided to ask Dr. Raffa to perform the necessary surgeries. This was the best decision I could have made.

Dr. Raffa and his staff of receptionists, administrators and assistants were all very competent, caring and kind, as were the members of the surgical team. The St. Mary’s hospital staff also provided me with excellent care. My surgery was a success, and I was home after a single night at the hospital.

It has been six months since surgery, and my recovery and healing have gone very well. My neck and shoulders feel so much better, and I’m no longer at risk for paralysis. I am back to my normal activities, including work and exercise.

I therefore wish to thank Dr. Scott Raffa, and all the staff at his office, for helping me in my time of need. You people are the Best!

To learn more about Paley Institute’s cosmetic height surgery, visit The Paley Stature Center Website.

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As cosmetic height surgery gains global attention, more individuals are seeking limb lengthening procedures to boost their confidence, stature, and self-image. In this in-depth Yahoo Entertainment feature, Dr. Dror Paley—founder of the Paley Stature Center and world-renowned expert in cosmetic stature lengthening—offers professional insight into the motivations behind the $200,000 surgery, the medical science behind the procedure, and why demand is steadily rising among adults worldwide.

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But everything changed when he traveled from Canada to the Paley Orthopedic & Spine Institute in Florida to meet world-renowned orthopedic surgeon Dr. Dror Paley.

Watch as Justin undergoes a complex, limb-saving procedure with a 100% success rate at the Paley Institute—restoring strength, stability, and the freedom to be a kid again.

Why Kids’ Bones Are Different: Understanding Pediatric Orthopedics

Children’s bones are continually growing and changing. This growth provides some advantages and poses some challenges:

Growth Plates: Kids have growth plates (physes) at the ends of long bones – these are areas of developing cartilage where new bone is made, allowing the bones to lengthen as the child grows. Growth plates are weaker than solid bone, so injuries in children often involve the growth plate. A twist or fall that might sprain an adult’s ankle could cause a growth plate fracture in a child’s ankle. The presence of growth plates also means kids have the remarkable ability to remodel mild angulations or deformities as they grow. For example, a child’s broken bone might heal slightly crooked but then straighten out over time as the bone lengthens. This is a big difference from adults – adult bones won’t correct themselves once healed, but kids’ often do to an extent.

Periosteum: Children’s bones have a thick, strong periosteum (the outer layer of bone) which is more active in healing. This means kids’ fractures heal faster than adults. It also means kids often get incomplete fractures – instead of a clean break snapping the bone in two, the bone may crack on one side and bend on the other, like a green twig. These are called greenstick fractures or buckle (torus) fractures. They’re common in children’s wrists and forearms because of that flexibility.

Ligaments vs Bones: In kids, ligaments (which connect bones at joints) are relatively stronger compared to bone than in adults. So a force that might cause a sprain (ligament stretch/tear) in an adult often causes a fracture in a child. It’s not always possible to tell a sprain from a fracture without an X-ray, so when in doubt, we evaluate for fracture.

Healing Potential: Because of rich blood supply and growth factors, children’s injuries generally heal quickly and well. Broken bones can heal in a matter of weeks (4-6 weeks for many fractures), and even surgeries like fixing a fracture with pins or plates usually show rapid recovery. However, the downside is that if a growth plate is significantly damaged, it can lead to growth disturbances (like one leg ending up shorter if the growth plate closes too early). That’s why any injury involving a growth plate needs careful follow-up for up to 1-2 years.

Understanding these differences underpins why pediatric orthopedic care is a specialty – treating children’s injuries and conditions requires knowledge of growth and development. As one pediatric ortho mantra goes: children are not just mini adults; they are still “under construction.” This is actually good news – it means they can often bounce back from injuries more easily, and sometimes less invasive treatments are needed because their bodies will take care of the rest.

Common Fractures in Children and Their Treatment

Fractures (broken bones) are among the most common injuries in kids. In fact, about 50% of boys and 40% of girls will have at least one fracture before age 16. Once kids start walking and especially when they become adventurous climbers, the risk of falls and injuries goes up.

Most Common Fracture Sites:

The wrist (distal radius) is the champion of childhood fractures. When kids fall onto an outstretched hand (FOOSH injury), it’s often the wrist that breaks. These can be buckle fractures or complete fractures. It’s so common that in an active practice we cast countless wrists every year.

The elbow is another frequent site, especially a type of fracture called supracondylar fracture (just above the elbow) in younger kids who fall off monkey bars or furniture.

The forearm (both radius and ulna) – kids often break both bones in the forearm.

The clavicle (collarbone) – a very common break from falls or sports, and even in newborns sometimes from birth trauma. You’ll notice a bump on the collarbone as it heals (that’s a normal healing callus).

The ankle – can be growth plate fractures around the distal tibia/fibula, often from sports or tripping.

For toddlers, a unique one is the “toddler’s fracture” – a small spiral break in the tibia (shin bone) from a simple twist while stumbling; child might just limp without a big trauma.

The femur (thigh bone) in younger kids, though strong, can break in high-energy falls or car accidents, or occasionally in a less severe fall if something else is going on (like bone cyst or osteogenesis imperfecta).

Fingers are also commonly broken (like getting caught in a door).

According to one source, aside from the wrist, other common fractures in kids include forearm, clavicle, and lower leg – which aligns with practical experience.

Signs of a Fractures vs a Sprain

It can be tricky to tell, and even doctors rely on X-rays to confirm. Some clues: If there’s obvious deformity (arm or leg looks “bent” where it shouldn’t be, or a bony bump sticking out), it’s a fracture for sure. Swelling and bruising occur in both sprains and fractures. Sometimes kids with a small fracture will still use the limb a bit, and you might not know – a limp or using the other hand more may be the only sign. Rule of thumb: if your child refuses to use the limb, or if pain and swelling are significant, they should be evaluated and likely get an X-ray. It’s better to check – an untreated fracture can heal wrong.

Initial Steps if you suspect a Fracture

Stabilize the limb: You can make a quick splint with a magazine or a pillow wrapped around the arm or leg to keep it from moving too much.

Ice and Elevation: This helps with swelling and pain.

Pain relief: Children’s acetaminophen or ibuprofen per recommended dose is fine to give.

Seek medical care: If deformity is present or pain is high, go to an emergency room. If it’s mild and you’re not sure, an urgent care or your pediatrician might do an initial check, but often they will refer you for X-ray anyway. If the limb looks very deformed or circulation is affected (fingertips/toes cold or pale) – that’s an emergency (call 911 or go to ER right away). For many pediatric fractures without deformity, it might be reasonable to wait until the next day to see an orthopedic specialist.

Treatment of Common Fractures

Casting & Splinting: The majority of children’s fractures can be treated non-surgically. A cast (typically made of fiberglass or plaster) immobilizes the bone to allow healing. Children usually need casts for shorter durations than adults – often 3-6 weeks is enough for many fractures. Some minor fractures don’t even require a full cast; a removable brace or splint can suffice. For instance, buckle fractures of the wrist often heal beautifully with just 3-4 weeks in a Velcro wrist brace – no hard cast needed. This is great because you can remove it for bathing and it’s more convenient. Pediatric orthopedists have been at the forefront of using removable splints for minor fractures to make life easier.

Reduction: If a fracture is displaced (the bone pieces aren’t aligned well), a reduction may be needed – that’s when a doctor manipulates the bones back into alignment. In kids, this is often done in the ER or clinic with sedation or anesthesia (they won’t feel it) and then casting. Children’s bones are a bit forgiving in alignment because of remodeling, but there are limits.

Surgery: Some fractures do need surgery – if the bone is badly displaced or if it involves the joint or growth plate in a way that must be precisely aligned. Common surgeries include:

Pinning (closed reduction and percutaneous pinning): For a badly broken elbow (supracondylar fracture), we align the bone and insert a couple of small pins through the skin to hold it in place.

Internal fixation: Using screws or plates for certain fractures, like a displaced ankle growth plate fracture or a femur fracture in an older child.

Flexible nailing: For femur fractures in kids, flexible titanium nails inserted into the bone can stabilize it without the need for a big surgical incision.

External fixation: Rarely, for complex fractures, a frame outside the body holds pins in the bone (commonly for some open fractures or those with wounds).

Healing and Aftercare

Kids usually manage well with casts – initial days they might be uncomfortable, but they adapt quickly. We advise:

Keep the cast dry (unless it’s a waterproof type, which some places offer for fiberglass casts with special lining – great for swimming and bathing!).

Keep it clean – kids like to shove things inside casts (itching can be an issue), but discourage that to avoid sores or stuck objects.

Watch for swelling: keep limb elevated especially first 48 hours and encourage gentle finger/toe movement to prevent stiffness.

Pain is usually much better after immobilization; a little pain medicine is used early on, but often kids need only minimal doses after the first day or two.

Follow-up visits: typically, an X-ray a week or two later to ensure alignment is holding.

Beyond Broken Bones: Common Injuries and Ailments in Active Kids

Not all orthopedic issues are fractures. Kids who are active in sports or play might encounter:

Sprains and Strains: Though younger kids are more likely to fracture than sprain, older children and teens (especially in sports) do get sprained ankles, knee injuries, etc.

Growth Plate Injuries (Physeal Injuries): Overuse can cause irritation of growth plates, leading to conditions like Sever’s disease or Osgood-Schlatter disease.

Dislocations: A common one in toddlers is nursemaid’s elbow, which is quickly fixable with a simple maneuver.

Sports injuries: In teens, we see adult-like injuries: ACL tears, patellar dislocations, or stress fractures in runners.

Concussions: Though not an orthopedic injury, concussions often accompany sports injuries.

When to see a Pediatric Orthopedic Specialist

If a fracture is suspected or confirmed.

If an injury isn’t improving in a few days or has persistent swelling/pain.

If your child has a limp or joint swelling without a clear injury.

For any growth plate fracture, it’s wise to have a pediatric orthopedist involved

Growth and Development: What’s Normal, What’s Not

Intoeing (“Pigeon-toed” walking): A common and usually benign condition.

Bowlegs and Knock-Knees: Normal in toddlers and preschoolers, but we monitor them.

Flat Feet: Common in toddlers; usually benign but can benefit from supportive footwear.

Toe Walking: Can persist past age 3 and may require evaluation.

Limping: If persistent or painful, requires evaluation for conditions like Legg-Calve-Perthes or SCFE.

Back Pain: Shouldn’t be a concern in younger kids; it warrants evaluation if it’s persistent.

Importance of Pediatric Orthopedic Care

Throughout all these scenarios, one theme emerges: children do best when treated by those who understand kids’ unique needs. A pediatric orthopedic specialist will:

Treat the whole child with growth in mind.

Use child-friendly techniques and equipment.

Offer family-centered communication to explain treatments.

Provide expert care and coordinate with other specialists when needed.

Conclusion: Growing Strong with Expert Care

Children’s bones have a tremendous capacity to heal and adapt, and with the guidance of pediatric orthopedic experts, most orthopedic problems in kids can be managed effectively, ensuring your child grows up with healthy, strong bones and joints. Our warm, understanding approach ensures that the care is not just top-notch in expertise, but also considerate of a child’s fears and a parent’s anxieties.

For a comprehensive evaluation and to explore your treatment options, don’t hesitate to schedule an appointment or seek a second opinion consultation with Dr. Arun Hariharan at Paley Orthopedic & Spine Institute by calling (561) 602-9155.