Girl, 3, in groundbreaking surgery
By Janelle Miles
04mar05
CHLOE Cutts is one in a million – and not just because she is the world's youngest patient to undergo ground-breaking orthopaedic surgery.
The three-year-old was recently operated on to have more than half her cancerous upper left arm bone removed and replaced with an artificial version designed to grow as she grows.
Chloe, from Manjimup in Western Australia, was last year diagnosed with Ewing's Sarcoma – a type of bone cancer that hits just one in a million children and young adults.
Her surgeon Ian Woodgate said she was part of a group of only six children worldwide to receive the fake arm bones which could be lengthened without surgery as she grew.
"She's by far the youngest patient to ever undergo this sort of technique," Dr Woodgate said.
Without the surgery to remove 11cm of her humerus at the Sydney Children's Hospital, Chloe's prospects were bleak with amputation a possibility.
So much so her mother Dianne described Dr Woodgate's announcement that Chloe was a suitable candidate for the procedure as like winning the Lotto.
Chloe's artificial bone – made from plastic which surrounds a spring-loaded mechanism – can be expanded using an electromagnetic field, eliminating the need for further traumatic operations until she is fully grown.
"This gives the child the chance of not only a normal-looking arm but ... a better functioning arm," Dr Woodgate said.
"Other options would have been to say, put in some donor bone and fuse the shoulder, or take a bone out of her lower leg and transplant it.
"This would have left her with ... significantly less function.
"She would have had 10 fingers and 10 toes but one arm wouldn't have moved all that much.
"With the new technology ... she'll be able to do all the things a young girl would like to do such as put on her makeup, comb her hair."
Dr Woodgate said Chloe's parents had not wanted to use an alternative prosthesis which could only be lengthened with surgery.
"They didn't want to go ahead with that option because ... every time you open (the arm) you have to cut the muscles and tendons, you have to risk infection yet again," he said.
"If we can keep them out of hospital, that's a huge bonus not only for the child but the whole family."
The Cutts may have had to settle for one of the less-ideal options if Chloe's uncle, Nick Markovski, had not found out about Dr Woodgate on the internet.
Last year the surgeon saved seven-year-old Samuel Nakkan's leg, replacing his thigh bone with a revolutionary expandable model in the first operation of its type in the southern hemisphere.
Dr Woodgate said a secondary benefit of the new technology was saving the health system money.
"We've calculated that with Sam, we'll probably save the health system around about $400,000 just because he's not going to need another operation now until he's about 17 or 18," he said.
"That's an incredible amount of money you can save not to mention the insult of putting them through multiple hospital procedures."
Eventually, Dr Woodgate said the technology may be adapted to help people with deformities such as those born with parts of bones missing.
"Do I think it will become more prevalent? I hope so, as long as we don't go outside the bounds of what the implant is designed for," he said.
"People will try and say just because I'm a short person, can I have the technology to be made taller?
"I don't think that's what it's aimed at."
As for Chloe, who returned to Western Australia this weekend, her long-term prognosis is good.
Although she will require further chemotherapy in Perth, Dr Woodgate said cure rates for children with Ewing's sarcoma were estimated at around 70 per cent at diagnosis.
By the time she is an adult and ready to have her artificial humerus permanently replaced, Dr Woodgate believes doctors will be able to grow bone for implants.
By Janelle Miles
04mar05
CHLOE Cutts is one in a million – and not just because she is the world's youngest patient to undergo ground-breaking orthopaedic surgery.
The three-year-old was recently operated on to have more than half her cancerous upper left arm bone removed and replaced with an artificial version designed to grow as she grows.
Chloe, from Manjimup in Western Australia, was last year diagnosed with Ewing's Sarcoma – a type of bone cancer that hits just one in a million children and young adults.
Her surgeon Ian Woodgate said she was part of a group of only six children worldwide to receive the fake arm bones which could be lengthened without surgery as she grew.
"She's by far the youngest patient to ever undergo this sort of technique," Dr Woodgate said.
Without the surgery to remove 11cm of her humerus at the Sydney Children's Hospital, Chloe's prospects were bleak with amputation a possibility.
So much so her mother Dianne described Dr Woodgate's announcement that Chloe was a suitable candidate for the procedure as like winning the Lotto.
Chloe's artificial bone – made from plastic which surrounds a spring-loaded mechanism – can be expanded using an electromagnetic field, eliminating the need for further traumatic operations until she is fully grown.
"This gives the child the chance of not only a normal-looking arm but ... a better functioning arm," Dr Woodgate said.
"Other options would have been to say, put in some donor bone and fuse the shoulder, or take a bone out of her lower leg and transplant it.
"This would have left her with ... significantly less function.
"She would have had 10 fingers and 10 toes but one arm wouldn't have moved all that much.
"With the new technology ... she'll be able to do all the things a young girl would like to do such as put on her makeup, comb her hair."
Dr Woodgate said Chloe's parents had not wanted to use an alternative prosthesis which could only be lengthened with surgery.
"They didn't want to go ahead with that option because ... every time you open (the arm) you have to cut the muscles and tendons, you have to risk infection yet again," he said.
"If we can keep them out of hospital, that's a huge bonus not only for the child but the whole family."
The Cutts may have had to settle for one of the less-ideal options if Chloe's uncle, Nick Markovski, had not found out about Dr Woodgate on the internet.
Last year the surgeon saved seven-year-old Samuel Nakkan's leg, replacing his thigh bone with a revolutionary expandable model in the first operation of its type in the southern hemisphere.
Dr Woodgate said a secondary benefit of the new technology was saving the health system money.
"We've calculated that with Sam, we'll probably save the health system around about $400,000 just because he's not going to need another operation now until he's about 17 or 18," he said.
"That's an incredible amount of money you can save not to mention the insult of putting them through multiple hospital procedures."
Eventually, Dr Woodgate said the technology may be adapted to help people with deformities such as those born with parts of bones missing.
"Do I think it will become more prevalent? I hope so, as long as we don't go outside the bounds of what the implant is designed for," he said.
"People will try and say just because I'm a short person, can I have the technology to be made taller?
"I don't think that's what it's aimed at."
As for Chloe, who returned to Western Australia this weekend, her long-term prognosis is good.
Although she will require further chemotherapy in Perth, Dr Woodgate said cure rates for children with Ewing's sarcoma were estimated at around 70 per cent at diagnosis.
By the time she is an adult and ready to have her artificial humerus permanently replaced, Dr Woodgate believes doctors will be able to grow bone for implants.
she's a brave little girl 
