Ask the Orthopedist: Dr. Lin

Why did you decide to specialize in pediatric orthopedics?

Pediatric orthopedics is more than being a general orthopedist for young patients. It is a demanding and challenging field where one has to understand and consider the broad spectrum of injuries and ailments associated with children at different stages of growth and development. Babies and toddlers typically present with simpler fractures, but are more commonly seen for congenital deformities, syndromes, malformations, such as torticollis, cerebral palsy, club, gait disturbances, and other developmental issues. School-age children come in with a plethora of bread-and-butter playground musculoskeletal injuries, such as fractures, sprains, and dislocations.  Adolescent and teenage patients present with more complex injuries and fractures, overuse injuries, “growing pains,” age-specific disorders (e.g. SCFE, Perthes, etc.), scoliosis, and joint derangements.  

In addition, we also consider how children heal in each stage of development – a forearm injury in a toddler may be treated in cast, whereas a pre-adolescent with the same injury needs surgery with rods, while a teenager/young adult needs be fixed with plates and screws.  It always amazes me when we hear young patients being treated by adult orthopedists 6-8 weeks in casts, when most of these kids are healed in half the time. Children are not small adults, and therefore, should not be treated the same way.  

Fortunately, most of the children we see are essentially healthy and are great healers.  As a result, we can meaningfully improve their quality of life and help them get back to the field or their interests and daily activities as quickly as possible.  The best part of the job is when a child gives me a hug, fist bump, high-five, or sends in a picture of themselves in action fully-recovered.

Tell us a little more about your specialty, in particular.

I specialize in trauma cases and sports injuries. As a child athlete and musician myself, I can relate to my patients’ desires to return to their sports and activities.  I will often modify my treatment plan in order for them to participate in some form or another safely.  For instance, I will often ask a patient what position they are playing in a sport and see if there is an opportunity to protect their injured limb while allowing them to participate to some extent.  I have been known to cast some wrist fractures in positions so the child can still play their instrument.  I do not have a cookie cutter approach to all injuries and treatments.  It is these nuances and details that I believe distinguish me from my colleagues.

Do you have a story about a special patient that you have treated?

I recently had a 15-year-old patient who had climbed and fallen out of a tree only to break his femur.  I saw him in the emergency room that afternoon with this terrible deformity, performed surgery that night and by the next morning, he was sitting in a chair at bedside, had seen the physical therapist, and was happily finishing his breakfast with no pain.  He was discharged and went home that morning walking with crutches.  It is incredibly gratifying to see a child walk out of the hospital only hours after such a tragic accident.

What is exciting to you about your field right now?

Playing sports is huge in our area of the country so much of my practice is focused on sports injuries. I see a considerable number of knee injuries, that include meniscal and ACL tears. Much of my decision making is dependent on how I can surgically repair/treat the knee safely, maintain its stability, provide long lasting function, minimize symptoms, and reduce chances of growth deformity and arthritis in the future.  The vast majority of my patients can be treated in ambulatory settings, where they are going home the same day and are ultimately able to return to their pre-injury levels of activities.  In the past, we, as orthopedic surgeons, were limited in treating ACL tears in growing children for fear of causing growth disturbances and lifelong deformities.  Nowadays, we have 6-8 different techniques, at last count, in reconstructing ACLs that safeguard these children at varying ages.  A 5-year old with an ACL injury is treated completely differently than a child going through puberty, which is also different than a more typical ACL reconstruction in a teenager. 

When you are not working, how do you like to enjoy your free time?

In my spare time, I enjoy traveling, spending time with my family, cooking various ethnic foods, downhill skiing, and playing tennis.