From Limitations to Limitless Possibilities: Blair’s Story

Blair is creative and artistic, with a deep love for drawing, swimming and riding her bike. But for much of her childhood, everyday tasks often felt like a challenge. Born with a rare condition called Madelung’s deformity, Blair’s wrists curved outward, causing pain and limiting her movement.

Her condition affected her confidence and her independence so much that her mom and dad, Jessica and Brandon, knew they needed to get Blair help.

Madelung’s deformity is an extremely rare, progressive pediatric condition found in fewer than one in about 3,300 children. The condition can cause a complete dislocation in the wrists with the hands angled forward.

But Valley Children’s Pediatric Plastic Surgery team and Pediatric Hand Surgery Program Director Dr. Michael Galvez had a bold solution using cutting-edge technology.

“When Blair arrived, it was clear that on both arms, she would need bilateral corrective osteotomies of the radius and ulna, the two bones that make up her forearm,” Dr. Galvez said. “Because it was a more severe case, I decided to do a 3D-planned approach.”

3D planning and printing had been used by the team for other types of wrist differences, particularly after trauma, but this would be the first time it was applied to Blair’s condition.

Exact copies of Blair’s bones were 3D printed, giving Valley Children’s Nurse Practitioner Lauren Perry and the rest of the reconstructive surgical team the chance to see and tangibly feel what Blair’s bones were like. This gave them invaluable understanding that they applied during the operation, so they knew exactly where they needed to cut and drill to reposition the wrist and put the hand back on top.

It also gave confidence to Blair’s anxious parents.

“They printed her exact radius and ulna and showed us what the surgery would involve,” said Jessica. “We could see it. We could hold it. They even let us look at the hardware they were going to install and showed us how and where it would be placed. We knew this was a complex surgery, but Valley Children’s had a clear game plan that gave us confidence and peace of mind with what was ahead.”

Given the complexity of the surgery (which would be done in two parts - one for each hand), Blair was the team’s sole patient that day. The surgical team kept in close contact after she was discharged and while she went through physical therapy, cared for by multiple specialists and involving custom splints. Blair’s love for drawing was incorporated into the challenging therapy as she worked on fine motor skills for her right hand.

Nearly a year later, Blair underwent her second surgery for her left hand, also preceded by the use of 3D printing to plan and coordinate the operation. Thanks to her increased strength and pain tolerance, Blair’s recovery was even smoother than that with her right hand.

Within two months, she was confidently using both hands and even performing tasks she wasn’t capable of before the operations. Today, she is drawing, swimming, riding her bike, cooking herself meals and more.

“Blair is back to doing everything she loves, and her confidence has completely transformed,” shared Jessica. “Blair is independent now. Best of all, she’s no longer hiding. She wears short sleeves and embraces all the things that make her uniquely Blair.”

“While the technical side is important for us to do it as precisely as possible, the most rewarding part of is seeing Blair’s transformation from almost hiding her hands to now being very confident,” said Dr. Galvez. “We had this child with one of the most complex differences that we’ve seen in the United States, something that is so different and challenging, and we were able to fully take care of her here.”