Pioneers in patient care: consultants leading change
North West
Professor Helen Carty
Royal Liverpool Children’s Hospital, Alderhey
Job title: Professor of paediatric radiology
Specialty: Radiology
Innovation: Introduction of percutaneous sclerotherapy for the treatment of aneurysmal bone cysts in limbs as an alternative to
open surgery.
Helen Carty is Professor of Paediatric Radiology at the Royal Liverpool Children’s Hospital, Alder Hey. She has pioneered a radiological alternative to open surgery for children suffering from aneurysmal bone cysts. The condition is rare but painful and results in localised swelling. The cysts can eat away at the bone, leaving a thin shell which is prone to fracture.
Professor Carty heard of the technique from a French colleague and introduced it to her hospital. It involves the injection of a fibrosing solution through the skin to repair the cyst instead of removing it surgically. Professor Carty worked in close collaboration with her orthopaedic surgeon colleagues who now perform the procedure. The injection is performed under CT control (computed tomography).
Professor Carty says: “This technique was originally introduced for a child whose cysts had recurred after surgery. We wanted to avoid further operations for the child and had extensive discussions with the child and parents before proceeding. It was successful and has now become the initial treatment of choice. The great advantage is that it replaces open surgery, which is not always successful and it avoids a scar. Although the percutaneous procedure requires an overnight stay, the child is in hospital for a much shorter period than with surgery.”
Feedback from patients and their parents has been very positive. Families are warned before the treatment is started that the child may require a second injection but as Professor Carty points out “Repeat surgery is often required too”.
The case for this innovation was clear. The technique is effective, it is aesthetically more acceptable, has a shortened hospital stay and is cost effective. Its success has been measured by the orthopaedic department which has followed up patients very closely. The repair process is monitored by radiographs.