Unique Surgery "Extends" Opportunities for Truman, Ark. Native

Maci Jayden England was born 2 months early weighing only slightly over 4 pounds. Urgent transport to Arkansas Children's Hospital (ACH) allowed doctors to stabilize her fragile health, and like many premature babies, she received a life changing diagnosis: Maci had cerebral palsy (CP), which means muscle spasticity that can affect one or all limbs and may affect learning ability.

"We were told what her symptoms would be as she grew; ACH was there to guide and help us through this," recalls Maci's grandmother, Nancy.

Maci was fitted with a multi-colored cast to match her colorful personality.

Fortunately, Maci had a milder version of CP that could be treated initially with a right-sided leg brace. As she grew and the muscles in her calf contracted, physical therapy and serial casting at ACH was necessary to stretch her tight muscles.

Botox has been used in Hollywood for cosmetic wrinkles but more recently it has been shown to help children with CP, like Macy, to relieve muscle spasticity. Botox is only a temporary treatment that must be repeated every 3 – 4 months. Botox can help with tight muscles by relaxing spasms but it cannot help if the muscles are contracted and scarred down, like Maci eventually experienced as she grew. At that point, surgery becomes the only option.

Around age 6 Maci's physical therapist told the Englands about a successful surgery, heel cord lengthening, that could help her walk without tip toeing. Heel cord lengthening surgery is done if a child develops a contracture or deformity of the ankle and foot due to tight muscles or tendons that can no longer be stretched out by therapy or bracing. Due to spasticity or tight muscles from very mild cerebral palsy affecting her right side (right hemiplegia), Maci was walking high up on her toe on that side.

Like most kids, Marci enjoys a dip in the pool.

Dr. James Aronson, chief of Orthopedics at ACH and a skilled surgeon, met with the Englands and determined that Maci was a good candidate for the surgery. "He explained every aspect of the surgery to her and let her ask him questions. He made her feel at ease the whole time," said Nancy

On Dec. 5, 2011, Maci underwent heel cord lengthening surgery performed by Dr. Aronson. The procedure lengthened the heel cord or Achilles tendon through an incision on the back of the ankle. The skin is opened to allow for an exact lengthening of the tendon, by a "Z" incision in the middle portion between the calf muscle and the heel bone. Strong sutures are then required for reattachment. The tendon takes about four weeks to heal in a cast, 2 weeks in a wheelchair and 2 weeks walking in the cast.

After the cast was removed, physical therapy helped Maci to walk with her heel down for the first time. Like astronauts in space, her heal bone had lost some calcium which required a few months to regain. Now she can walk without braces!

"Her everyday activities improved 100-percent and she has just been released form physical therapy for the first time since she was 6 months old," Nancy proudly shared.

While her mobility was once limited, heel cord lengthening surgery has enabled Maci to live a full, active life, even dancing in 'The Nutcracker'.

Maci's diagnosis of cerebral palsy hasn't slowed her down a bit; she has been a PeeWee cheerleader at her school, competed on a swim team, played softball and soccer and has taken dance classes for years. Maci's real passion is theater. She has performed in the Nutcracker at the Jonesboro Foundation of Arts in three different productions and has been in other plays as well.

Currently a sixth grader, Maci is in the Gifted and Talented program, participates in the Odyssey of the Mind and is on the Quiz Bowl team.

Nancy credits Maci's active nature and her many talents to the treatment she received at Arkansas Children's Hospital throughout the years. "With the help and guidance of ACH, Maci has gone far. You have made it all possible for her. She is able to walk, and most of all, ACH has made life easier for her."

Betsy Aronson, her APRN in the ACH Orthopedics department and the Englands have bonded over the years. "Maci is a great girl – very upbeat and motivated," Betsy says. "She is an actress, singer, dancer and cheerleader who doesn't let her condition slow her down a bit. As a matter of fact, most people probably never notice any problem - all they see is a talented girl with a great personality!"

Nancy takes every opportunity to thank the staff of ACH: "Thank you ACH, Dr. Aronson and all the staff for all you have done for Maci and all the other children you've helped. You are a blessing."

If you think your child could benefit from the care at Arkansas Children's Hospital, ask your physician for a referral. They can connect with our team of experts who offer nationally recognized outcome rates by calling 1-800-249-3232.