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OrthopaedicsIt was shortly after one of Nebraska's biggest blizzards of 2009 that dumped up to 2 feet of snow in parts of northeastern Nebraska. Krista Reynoldson was doing what kids do after a big snow. She was outside throwing snowballs, sledding down hills and climbing up snowdrifts. Some of the drifts were especially high at the family's farm in Albion, Neb., where mountainous drifts dotted the landscape like moguls on a ski slope. With a little imagination, the 15-foot snowdrift behind their house became Mount Everest. Five-year old Krista and her 7-year-old sister, Erin, pretended they were climbing the mountain while their mother, Lisa, snapped pictures.

Just as Lisa turned to put her camera away, she heard a scream from Erin. Lisa looked up to see that Krista had fallen backwards off the snowdrift into a pen alongside the buried chicken house.

"I quickly asked her to stand up so I could help lift her over the fence," says Lisa. "But as soon as she tried to get up, she screamed. That's when I saw her right leg swinging."

Five months pregnant, Lisa climbed over the 7-foot fence, covered Krista with her coat and sent Erin for help. Fortunately, it was a Sunday and her husband Jason was home. With the help of Jason's parents, they slid Krista onto a sled and pulled her to their SUV. They laid Krista gently in the back and drove to the county health center.

X-rays revealed that Krista's femur was completely broken in two. The bottom half had slid up next to the upper half of the bone so that they sat parallel to each other.

Orthopaedics"I can still hear her screams of pain," recalls Lisa. The medical staff at the county health center was not equipped to handle a break of this severity and recommended they seek care in Omaha. "The medical staff gave her some pain medication which put her to sleep as we got ready for a long ambulance drive," says Lisa.

Two and a-half hours later, Krista and Lisa arrived by ambulance in Omaha at Children's Hospital & Medical Center. Jason had stayed behind to get the rest of their children settled with grandparents and arrived a short time later. "We immediately felt like we were in good hands," says Lisa. "There was a team of doctors waiting for us and they took control of the situation immediately."

Orthopedic surgeon Susan Scherl, M.D., who specializes in orthopedic trauma, discussed Krista's options with Lisa. Dr. Scherl has been named for the third time to the "Best Doctors in America," by Best Doctors Inc.

Krista had two options, she could have two rods placed in her femur with no cast, but she would be required to use a walker and wheelchair for several weeks, or she could bypass the rods, but she would have be placed into a body cast up to her waist to stabilize the legs and hips. Lisa chose the surgical option, as it would allow Krista to be more mobile and go back to school. "I was a nervous wreck," says Lisa. "I've never known anyone who had broken a bone before."

But Dr. Scherl's confidence brought some comfort to Lisa. "I knew she would take good care of Krista," she says.

"Krista was lucky," says Dr. Scherl. "If the break had been any higher it would have been a much more difficult surgery." The procedure, which Dr. Scherl has been performing for about the last 10 years, involves inserting two thin, flexible metal rods into the femur just above the knee and up through the hollow area of the bone. The rods extend the length of the bone and hold the two pieces together. The former method involved inserting two metal rods horizontally through the bones. The rods extended beyond the skin and were hooked together outside of the leg to stabilize them. "The old way left some pretty big scars and caused damage to the muscle," notes Dr. Scherl.

Not only is the newer technology aesthetically pleasing, but it also leaves less scarring, allows the patient to be up and around much sooner after surgery and results in less opportunity for infection.

Krista had the surgery performed that same night and was ready to head home on Tuesday. After two weeks at home, Krista returned to school, wheelchair and all.

"Krista adapted really well," says Lisa. "She never complained, and actually, she loved being in the wheelchair. The kids made a game of it. Krista would speed around the house and her sister would issue her speeding tickets." On several instances, Krista was reprimanded at school for going too fast.

After seven weeks, Krista transitioned to a walker and gradually began physical therapy to strengthen her muscles that had weakened quite a bit over her three-month recovery. "She really missed the wheelchair," laughs Lisa. "She didn't want to give it up. It never slowed her down. Anything she wanted to do, she figured out a way to do it whether she was in the wheelchair or using the walker."

Approximately 10 months later, Krista went back to surgery to have the rods removed. "Now you can't even tell she broke her leg except for a small scar on her knee from the stitches," notes Lisa.

"The femur is a pretty forgiving bone," says Dr. Scherl. "It heals nicely. Most children do not have long-term side effects. Kids are very adaptable. It's often harder for the parents than the child."

The entire event is now just a small bump in the road for Krista. To Lisa's dismay, with the first big snow the following winter, Krista was rearing to get back on the snowdrifts again. "It never fazed her," says Lisa. "I'm just so glad we had a doctor like Dr. Scherl to get us through this. She was wonderful."