Summer 2011

Mending and Preventing Pediatric Injuries

SabatiniWhen a child breaks a bone, treatment demands more than an understanding of the injury and the medications necessary to ease the pain. "Part of any child's healing process involves helping them understand what happened and how their body will mend," said pediatric orthopedic surgeon Coleen Sabatini, M.D., M.P.H. That's the advantage of having children with orthopedic injuries receive treatment in a child-friendly environment, with clinicians specifically trained to work with children, she said.

"Orthopedic exams with children, especially young children, can be difficult," Sabatini said. "To build the level of trust necessary for a proper exam and treatment — and for a child to recognize he or she plays a role in healing — you have to be very creative in evaluating and discussing the injury. It's a challenge and a responsibility, so you have to love taking care of kids and relish the opportunity to participate in their lives."

State-of-the-Art, Clinically Integrated Care

The combination of pediatrics and orthopedic surgery is not always easy to find, which is why Sabatini and her colleagues in the UCSF Department of Orthopaedic Surgery are available not only at UCSF Benioff Children's Hospital, but also at satellite clinics in Greenbrae, San Ramon and Santa Rosa. Whether they're treating complicated trauma or a simple fracture, their goal is to return children to their normal activities as soon as it's safe.

Doctor Examining ChildSabatini also noted that for children with more complex diagnoses, where other medical issues complicate an orthopedic concern, it's especially important that specialists from different disciplines communicate directly with one another to better coordinate treatment. For example, children with cerebral palsy frequently have pulmonary issues as well. When surgery becomes necessary, close communication between the orthopedic surgeon and the pulmonologist, as occurs at an academic medical center, can ensure each child is medically optimized before surgery.

The Public Health Perspective

Such optimal medical care is important, but Sabatini's strong background in public health also fuels a drive to dramatically reduce the demand for her surgical expertise. She expects to begin a research effort with that goal in mind.

"I'm committed to looking at how and why children sustain injuries, and what we can do to prevent their occurrence," she said. "For every kid with a cardiac event, there are hundreds of preventable orthopedic events. By evaluating the origins of injuries in a community, it is possible to mitigate the risks and see demonstrable improvements. If we can avert the loss of time from school and parents' work, as well as the social implications of a child not participating in normal activities, that's a real community benefit."

For more information, contact Dr. Sabatini at (415) 353-9372 or (925) 866-2660.

Summer 2011 Table of Contents

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