Mutton Bustin’ and Flexi Nails: Expanding to Meet the Pediatric Orthopedic Needs of Northwest Arkansas

Alex Jandebeur has seen a lot of broken bones. He’s been an X-ray technician since he was 20 years old and now trains new technicians in northwest Arkansas. When his son, Aiden, broke his femur at a skatepark, he said he knew, “I needed the specialty care that [Arkansas Children’s Northwest] has.”

The sentiment has become more common since 2018, when Arkansas Children’s Northwest (ACNW) opened its doors and began providing care in the region.

How has the ACNW orthopedic team earned the trust of the community? The short answer is – repeatedly delivering exceptional, pediatric-specific care to one family member at a time.

When one of the world’s largest retailers targeted northwest Arkansas for development, the region’s population grew significantly, increasing over 40% from 2010 to 2025. Arkansas Children’s – the state’s only health network dedicated to pediatric care – responded by opening ACNW, a five-story pediatric hospital, in Springdale, Ark., in 2018.

Three years after opening ACNW, Arkansas Children’s recruited Adrienne Koder, D.O., a board-certified pediatric orthopedic surgeon, to lead ACNW’s orthopedic team and provide exceptional care in one of the fastest-growing regions in America’s heartland.

Dr. Koder is the operating room medical director, vice chief of staff and chief of orthopedics at ACNW, and an assistant professor in orthopedic surgery at the University of Arkansas for Medical Sciences. She leads an orthopedic team that includes:

• Four additional orthopedic surgeons
• Four orthopedic physician assistants
• Three surgical hospitalists

The team provided care for patients in nearly 10,000 orthopedic clinic visits in 2024, a number that’s increased every year as the hospital, her team and their reputation have grown.  

Traumatic pediatric orthopedic injuries – fractures – are one of the conditions for which parents will most frequently take their children to a non-pediatric hospital or clinic. With a broken or fractured bone, parents tend toward the closest option. Alex Jandebeur and his wife, Katie, are examples of parents choosing ACNW even when it isn’t the closest option. 

“Whenever we have a family bring one child here, they understand the difference pediatric specialists make, and then they bring all their kids here,” Dr. Koder says. “It’s very common for me to operate on one child, and then their cousin or their brother will get treated here.”  

Looking back on how he felt during every stage of Aiden’s treatment, Alex said, “This place made us feel really good. Across the board, they worked really hard to make us comfortable.”  

Many factors contribute to creating a positive experience during a stressful time, including a colorful, welcoming hospital designed around the principles of “delight and discovery,” staffed by people trained and dedicated to meeting the unique needs of children.

Flexi Nails

Dr. Koder says flexible intramedullary nails (commonly called flexi nails) are an example of pediatric-specific care her team provides. The minimally invasive procedure, taught during pediatric fellowships, involves inserting two flexible, lightweight nails through the bone canal to stabilize the fracture while allowing continued growth as the injury heals. Orthopedic surgeons who haven’t completed a pediatric fellowship may default to treating fractures requiring surgery with plates and screws. For appropriate fractures, flexi nails allow for smaller incisions, less time in surgery and quicker recoveries. Flexi nails are also easier to remove once the bone has healed, which avoids any potential complications of leaving permanent hardware near a growing bone.

Dr. Koder says that the commitment to providing excellent care extends beyond the individual patients. “Our orthopedic team is always ready to care for the entire family. Going through surgery is a tough time for everyone in the family. We have ortho specialty nurses who ensure every question the parents may have gets answered.”

Mutton Bustin’

Establishing themselves in the community also helps pediatric orthopedic specialists build trust. Dr. Koder, who moved from Manhattan, NY, had never heard of mutton busting until moving to northwest Arkansas, home of the Rodeo of the Ozarks. Through her patients, she’s gained familiarity with one of the rodeo’s main attractions – mutton bustin’.

Children (typically ages 4-9) ride on a sheep's back, trying to hold on for as long as possible to earn a score, similar to bull riding but with sheep. Participants wear protective gear, such as helmets and long pants, but awkward falls sometimes result in injury. Mutton bustin’ carries the risk of arm fractures for young children.

Arkansas Children’s orthopedic specialists also have extensive experience diagnosing and treating the unique fractures caused by ATV accidents, seen frequently across the region.

Whether it’s a rodeo tumble, an ATV rollover or a playground mishap, families across northwest Arkansas know they can turn to a team that understands pediatric care and the community. This deep-rooted trust – built one child, one family at a time – continues to strengthen the ACNW orthopedic program.

Continued Growth

When Dr. Koder joined ACNW, it was a 248,000 sq. ft., five-story hospital with 24 inpatient beds, five operating rooms, a 24-hour pediatric emergency department and 30 outpatient clinic exam rooms shared among 30 subspecialties. As part of Arkansas Children’s historic $318 million expansion, ACNW has gained 72,000 square feet of space to accommodate more inpatient beds, operating rooms, clinic spaces and a 70% increase in providers.

With expansion underway, ACNW is positioning itself to meet the region’s growing needs for decades to come. The orthopedic team – already a cornerstone of pediatric care in the area – is poised to deliver even more life-changing care to more families across northwest Arkansas and beyond.

* This article was written by the Arkansas Children’s content team and medically reviewed by Adrienne Koder, D.O.