"We were already planning to take Dominick to the doctor for a problem with his foot -- there was an extra bone sticking out. Then just before the doctor's appointment, my husband noticed Dominick was limping and that one of his buttocks was lower than the other. We mentioned this during the appointment. The doctor ordered some additional testing, and that's when we found out one of his legs was shorter than the other," says Dominick's mother, Bonnie. The boy was fitted for a one-inch shoe lift, an adequate but not ideal solution. "Dominick was sensitive about the shoe lift -- some other kids made fun of him -- and he worried it might hurt his chances of having an acting career when he gets older," Bonnie says. After almost two years with the shoe lift, Dominick's parents decided to explore other treatment options for their son. After a careful search, the family chose John Parenti, MD, a Janet Weis Children's Hospital pediatric orthopaedic specialist. "Dominick was already diagnosed and wearing the shoe lift when I first met him, so my role was to explain risks and benefits of other options," says Dr. Parenti. "We performed a scanogram, a special X-ray with a ruler, several times to confirm the leg length discrepancy and determined that Dominick's deformity was mildly progressive and caused by asymmetrical development in the growth plates in his right tibia (lower leg bone)." Faced with three alternatives -- the shoe lift, surgery to lengthen the right leg, or surgery to stop growth in the shorter leg -- Dominick and his parents opted for the bone-lengthening procedure. Dominick, then 11, was scheduled for surgery at Janet Weis Children's Hospital in July 2003.
During the procedure, performed under general anesthesia, the right tibia was cut and six metal pins were inserted into the bone -- three below Dominick's knee and three above his ankle. A metal device called a fixator was attached to the pins, which later would be used to gradually pull apart the tibia, creating a gap that would eventually fill in with healthy new bone. During the operation, Dr. Parenti also removed a bony projection from Dominick's foot, correcting a secondary orthopaedic disorder. "Surgery took about three hours. We were nervous. When he came out, he had the fixator in his leg. We had to crank it a quarter millimeter four times a day to stretch the bone," recalls Bonnie. "When I first saw Dominick after surgery, it was a shock to see the metal pins sticking out of his leg, but you learn to accept it. You know what you have to do and that it has an ultimate benefit for your child," adds Dominick's dad, Dominick Sr. After two days at Janet Weis Children's Hospital, Dominick was discharged, but his ordeal was far from over. The fixator would remain in his leg for five months, and the pins, which are drilled into the bone through the skin, required daily cleaning to prevent infection, a major risk of the surgery. "I thought cranking the fixator would be awful, but the worst part for me was cleaning the pins every four hours. The skin would grow around the pins, and we had to pull it away to clean the area properly. It was agonizing for Dominick," Bonnie says. "You want to protect your child -- not inflict pain. It was hard." For more than a month after Dominick's surgery, Bonnie and her husband painstakingly cranked the fixator in Dominick's leg exactly one quarter millimeter. This stimulated the growth of new bone in the space between the parts of the tibia that were cut during surgery. In addition to cranking the fixator, Dominick endured the excruciating process of cleaning and sterilizing the pins for five months. Dominick remembers: "For the first couple of weeks, it was really tough. The worst part was the cleaning. It hurt so bad. One of my biggest inspirations was Reba McIntyre. I listened to her music while the screws were being cleaned and sung along really loud. It was tough, but I got through it." During Dominick's long healing process, he used crutches and eventually borrowed a motorized scooter from his aunt so he could spend time outdoors with friends and resume daily activities. He performed in Pocahontas with the fixator in and later landed a role in Aladdin when wearing a walking cast. The director of Pocahontas incorporated Dominick's fixator into his character, explaining that the young warrior had suffered a leg injury. After the fixator was finally removed in December 2003, Dominick spent six weeks in a full-length cast that spanned hip to ankle and then another six weeks in a walking cast from the knee down. He began physical therapy in Wilkes-Barre in summer 2004, a year after the life-changing surgery. His recovery continues today. "I'm feeling really good. I'm happy that I don't have to wear a heel on the bottom of my shoe. That makes it great. I'm able to perform with my theater group and not feel self-conscious about wearing a shoe lift," Dominick grins. | 
