Revolutionary Surgery Enables Active 12-Year-Old to Step On Up

Dr. Widmann's patient, Siva, made him a card that said "Best Doc Ever" on Valentine's Day.

Siva Nirmalakumar is an energetic 12-year-old who likes to draw, play the drums, go on the computer, shoot basketball hoops and run around. Until recently, though, playing basketball and running around were a bit of a challenge.

When Siva was born, he developed an infection in his right leg. Although it was treated at the time, it later affected the way his thigh bone grew and developed. When he was in third grade, a physical therapist at his school noticed his right leg was a little shorter than his left one. The therapist recommended a shoe lift, and Siva’s pediatrician agreed. But by fifth grade, the difference was more becoming noticeable.

Over the years, Siva’s parents took him for periodic check-ups at the New York City hospital where he was treated as an infant. He also saw his pediatrician for a yearly physical. Although the difference in Siva’s leg lengths was getting bigger, and his right leg was starting to look crooked, the physicians did not recommend treatment, recalls Siva’s sister, Nitiya, a 21-year-old college student. “All the doctors who examined him said it was something he would have to live with,” she said. “We didn’t know what to think. We had heard about other deformities like club foot, but knew nothing about one leg being shorter than the other.”

Dissatisfied with the care their brother was receiving, Nitiya and her older brother took to the Internet to research Siva’s condition and find a doctor and hospital that could help him. They came across the Hospital for Special Surgery website, where they discovered a wealth of information and Dr. Roger Widmann, Chief of Pediatric Orthopedic Surgery. The very next day, they called to make an appointment.

By the time they went to see Dr. Widmann in May of last year, Siva’s right leg was two inches shorter than his left leg, and he was tired of the extra foam heel attached to the bottom of his right shoe. “The shoe lift was bothering me because I couldn’t run and play the way I wanted to,” he says.

Siva and his family took to Dr. Widmann immediately. “He was wonderful. He told us there were a number of different treatment options to fix Siva’s leg. He explained everything really well,” Nitiya recalls.

Dr. Widmann determined that by the time Siva finished growing over the next several years, his right leg would be four inches shorter than his other leg. Various surgical techniques are available to make both legs the same length, and Dr. Widmann explained all of them to the family.

The Nirmalakumars and Dr. Widmann decided Siva would have two surgeries on his right leg. The first one would straighten the bone where it turned inward at the knee. That was in July of last year, and it went well. The second surgery, in September, entailed a relatively new procedure that had revolutionized limb-lengthening surgery. Known as the PRECICE system, it uses magnetic lengthening rods and an external remote control to make the bone longer. “We have found the results of the lengthening rods to be excellent, and Siva was a good candidate for the procedure,” Dr. Widmann said.

A thin magnetic lengthening rod was implanted into Siva’s shorter bone through a small incision. After three days and two nights in the hospital, he went home, where treatment would continue. His mother or his sister applied an external remote control to his leg several times a day painlessly lengthening the rod – and the bone – in tiny increments until his desired leg length was reached.

Siva was able to go back to school with crutches two days after leaving the hospital. The lengthening process using the remote control magnet went on for about six weeks, and Siva saw Dr. Widmann every two weeks to make sure everything was going as planned.

The procedure was a success, and the Nirmalakumars are grateful for the care Siva received. “HSS is like a second family,” Nitiya says. “The whole staff is wonderful, and Dr. Widmann is an amazing doctor. He’s encouraging, he’s insightful, he’s a very good person. I can’t begin to tell you how helpful he is. You don’t get this anywhere else.”

Siva agrees. “HSS took really good care of me,” he says. “Dr. Widmann is the number one person at HSS. He made my life better. He fixed my legs, he gave me great advice. He changed everything for me.”

Siva still goes to physical therapy to build his strength and has a lot to look forward to. He’s eager to resume basketball, go swimming and help his family with chores around the house. He says he also likes dancing, and now he’ll be able to perfect his favorite move, the moonwalk.