Posted by Brigham and Women's Hospital April 21, 2014
Imagine a world where patients with severe limb injuries – like survivors of the Boston Marathon bombings – could hope for better recoveries, with muscle, cartilage, and bone regenerated.
That vision draws closer every day, according to Brigham and Women’s Hospital (BWH) researchers. They are hopeful that a new initiative, the Gillian Reny Stepping Strong Fund, will fuel breakthroughs for patients with traumatic, athletic, military, and disease-related injuries.
A year ago, Audrey Epstein Reny and Steven Reny were standing near the Boston Marathon finish line with their daughter Gillian, cheering on the runners and waiting for their oldest daughter Danielle to cross. When the bombs went off, the Renys were among the many innocent bystanders who were injured, Gillian critically.
The family was rushed to BWH, where clinicians worked to save Gillian’s life — and both of her legs. On that tragic day, dozens of patients were treated at BWH for similar injuries.
While Gillian’s condition was serious, doctors determined that her wounds were stable. Orthopedist Mitchel Harris, MD, together with plastic surgeons Christian Sampson, MD, and Eric Halverson, MD, devised the treatment plan. They took healthy tissue from Gillian’s abdomen and microscopically connected the blood vessels to keep the tissue alive. A stabilizing rod inside her tibia was placed to hold the bone in the proper alignment, length, and rotation.
“She had a terrible bone injury, which the orthopedic service stabilized very well. Remarkably, the main blood vessels and nerves to her lower leg were intact. And that is what set us on the direction of limb salvage rather than amputation,” says Dr. Sampson.
Out of tragedy, the Reny family has created something of great promise. The Stepping Strong Fund will support three areas.
Stepping Strong Research Scholars
Researchers are using stem cells to better understand the effects of age, hormone deficiency, and vitamin D deficiency on bone-forming cells. The team also will explore ways to salvage limbs that hold promise to restore normal function with less pain.
Stepping Strong Trauma Fellowship
This initiative will train the next generation of trauma surgeons in advanced techniques for treating acute and complex injuries. Fellows will learn surgical management, rehabilitation, limb reconstruction, and scar management.
Stepping Strong Young Innovator Awards
Competitive annual awards will inspire innovative research in areas including limb regeneration, limb transplant, advanced stem cell technology, orthopedic and plastic surgery, and bioengineering.
Those involved are hopeful that the Stepping Strong Fund will lead to breakthrough technologies in the management of all patients with traumatic, athletic, military, and disease-related injuries.
According to Dennis Orgill, MD, PhD, Medical Director at the BWH Wound Care Center, of the 185,000 people who have amputations each year, most start with a wound that does not heal. “By combining advanced stem cell technologies with dermal scaffolds, we hope to develop better methods of regenerating skin and healing wounds, dramatically reducing the pain and suffering of amputation,” says Dr. Orgill.
“Bone has a remarkable regenerative capacity,” adds senior scientist Julie Glowacki, PhD. “But for various reasons – age, nutritional, vitamin D, or hormone deficiencies, for instance – some patients have a limited capacity to heal. This award will help us to better understand the mechanisms of fracture healing.”
“Our hope is to one day have the capability to regenerate muscle, cartilage, and bone lost to traumatic injuries or even from tumors. Once we figure out how to predictably regenerate bone through the enhanced activation of osteoblasts (bone-forming cells), the scaffolding for even greater reconstructive initiatives will be accomplished,” says Dr. Harris.
Watch the steps that Gillian Reny has taken toward recovery.