Dr. David Feldman fine-tunes Julia Breitenbach’s prosthetic lower leg, adorned with a picture of Hannah Montana (top). (Photos by Andre Watts)

"I’m Really Good. Watch Me."

At HJD’s Center for Children, Only the Best Will Do

There’s something about the twinkle in Julia Breitenbach’s eyes, something that makes you think that with this spunky nine-year-old, anything might be possible. When you see her kick around a soccer ball—not much differently than the other kids on the playground—with a prosthetic leg for support, you know that anything is possible.

“I’m really good,” she says as she chases the ball. “Watch me. It’s easy!”

But that wasn’t always the case. Julia was born with a rare congenital disease called fibular hemimelia that deformed the bones in her left leg, which ends several inches above the knee. She had learned to walk using a prosthetic lower leg—attached to a long thighbone created by pinning together two other bones—but her overall function was still very poor. The long thigh made her legs uneven, and as a result, she was unable to bend at the knee properly.

“It’s hard to move when you can’t bend,” she says of the time when she had trouble sitting in the car and would accidentally kick other children at the lunch table. “It hurt to play. I couldn’t really keep up with the other kids.”

Julia lived like that for eight long years before she came to see David Feldman, MD, chief of pediatric orthopaedic surgery at the Center for Children, part of NYU Langone Medical Center’s Hospital for Joint Diseases (HJD). With 8,000 visits from children annually, the center treats diseases ranging from scoliosis to cerebral palsy.

“She was barely functioning,” recalls Dr. Feldman, associate professor of orthopaedic surgery. “It was unacceptable. I took one look at her and said, ‘We have to do better.’ ” He knew that Julia would never be able to use a state-of-the-art prosthetic without a matching state-of-the-art amputation. So last year, Dr. Feldman did what Julia and her parents had once thought impossible: he fixed her gait. First, he shortened the thigh and realigned the bones so that her knees could be even. Then, he created a more-rounded stump that would accommodate a prosthetic more comfortably. “Sometimes more amputation is the best answer,” explains Dr. Feldman, who often needs to lengthen a patient’s limbs. “The prosthetics are so advanced today. You need a good amputation to wear a good prosthetic.”

Children who wear prosthetics need more specialized care than adults, he explains. “Kids are tougher than adults. Their prosthetics constantly need to be examined and adjusted as they grow, and that’s something very few hospitals know how to do.”

By dint of physical therapy and sheer will, Julia is back on the field only a few months after surgery. She uses her new prosthetic to its fullest potential—and ignores it at the same time. “Dr. Feldman realizes that mere function is not the goal,” says Julia’s mother, Jackie. “The true goal is achieving the optimal result. That’s what differentiates the Center for Children from other places we’ve gone to for treatment—the realization that every child has a personal best, and the willingness to help her achieve it.”

“My life has changed a lot since the surgery,” Julia says proudly, pointing to the picture of Hannah Montana that she had printed on the face of her prosthetic. “It hurts less to play. I can kick the ball much better now. I can bend my knee. Life is easier than it used to be.”