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Surgery Lets Italian Girl Take Steps

May 18, 2002

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NEW YORK (AP) _ Martina Croce had spent her entire young life lying flat on her back _ her contorted legs unable to move because of rare disorder of the joints. Her parents were told she would never walk.

But after a nine-hour operation at Manhattan’s Hospital for Special Surgery, the 2-year-old Italian girl took her first steps this month.

``It’s really like they say _ this is America. It’s a dream,″ says her mother, Simona Croce.

Simona Croce focused through happy tears as her video camera captured her child standing and slowly moving her foot forward, aided by a physical therapist and leg braces.

Martina’s 4-year-old sister, Asia, also beamed.

``Bravissima!″ their mother yelled in Italian. ``Want to dance?″

The disorder, called arthrogryposis multiplex congenital, is typically the result of a fetus that has too little room to move in the uterus, causing protective tissue to grow around the joints and fixing them in position. Martina’s particular type of arthrogryposis _ meaning ``stiff joints″ _ occurs in one out of perhaps 50,000 births, said Dr. Stephen Burke, a pediatric orthopedic surgeon at the Hospital for Special Surgery.

When Martina was born, ``her legs looked like a frog’s,″ says her grandmother, Gabriella Alborghetti. With knees locked in a 90-degree position, elbows stiff and arm muscles limp, the little girl would be dependent on others for everything.

``I downplayed her physical condition, because she had a face that was so beautiful that I said, ’She seems like an angel,‴ said the grandmother.

Martina’s family never gave up hope. In Milan, they met another child in physical therapy who had been operated on by Burke; that mother had found him on the Internet.

An Italian charity called L’Amore del Bambino _ meaning ``love for the child″ _ covered part of Martina’s costs, along with private donations, and the hospital lowered its charges, which can run into six figures.

Only a few U.S. hospitals perform the rare surgery. It involved removing one bone from each twisted foot to straighten it, and releasing the tight ligaments on each knee. The nerves and blood vessels were so taut that Burke also had to shorten the femur about an inch to release the pressure.

Then came six weeks in a body cast. Since then, for 45 minutes each day, therapist Cathi Wagner takes Martina through movements that are new to the toddler, including gleefully rolling herself over again and again. The workouts also produce moments of pain.

Eventually, Martina may face more surgery: a muscle transplant from the legs to the arms, so she can bend her elbows and feed herself.

``I anticipate that she will be functional,″ says Burke.

The family will return to Milan by the end of the month. Martina’s mother plans to take her back to the Italian doctors who had concluded she would never walk. She hopes Martina will inspire them to help other Italian children born with the disorder.

___

On the Net:

Hospital for Special Surgery: http://www.hss.edu/welcome2.asp

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