Growing up in Birmingham, Ala., Charles A. Goldfarb was the youngest son of a head and neck surgeon. His older brother and sister became lawyers, but Dr. Goldfarb initially thought he might follow his father’s path. Then he was exposed to orthopedics, and he knew he’d found his calling.
“What had attracted me to head and neck surgery was the intricacy of the anatomy,” says Dr. Goldfarb, chief of orthopedic surgery at St. Louis Children’s Hospital and co-chief of the hand and wrist service at Washington University School of Medicine in St. Louis. “But the area around the hand also is very intricate, and from my perspective, those are the two most interesting anatomical areas of the body.”
Another attraction was the link between orthopedics and sports. Dr. Goldfarb was a history major and a varsity college soccer player at Williams College in Massachusetts, proudly representing the school that gave the world Stephen Sondheim, John Sayles and perhaps the best mascot name in all of athletics: Ephelia the Purple Cow.
Sports have remained part of his professional life. When athletes need hand surgery, his phone rings.
“I like to say my practice has three parts, and it’s an unusual combination,” explained Dr. Goldfarb, who treats patients through Washington University Orthopedics as well as Children’s Hospital.
“One part involves taking care of kids, particularly kids with birth differences, which is where my love and my research lie. The next part is sports — athletes at all levels. It started because the St. Louis Rams needed a hand surgeon, and I have since been fortunate enough to take care of players from the Blues and the Cardinals and other places, too.”
The third part of his practice involves treating more common hand problems, including carpal tunnel syndrome, broken fingers and lacerations.
“Dr. Goldfarb is a superb surgeon with an extraordinary range of talents,” said Regis J. O’Keefe, MD, PhD, the Fred C. Reynolds Professor and head of the Department of Orthopaedic Surgery. “Children with the most complex hand deformities and elite athletes from all over the country come to St. Louis for his care. His commitment and personal qualities make him a role model for our residents and a trusted colleague and leader in our department.”
RIGHT PLACE, RIGHT TIME
After Williams College, Dr. Goldfarb returned to Birmingham for medical school at the University of Alabama at Birmingham, where he fell in love with orthopedic surgery. In 1995, his residency brought him to Washington University School of Medicine, just as Richard H. Gelberman, MD, became the inaugural head of the Department of Orthopedic Surgery. Dr. Gelberman had begun assembling a faculty of experts in several orthopedic specialties.
The late Paul R. Manske, MD, also a hand specialist, had directed the university’s Division of Orthopedic Surgery before it became a department.
“His practice focused on kids with birth differences,” Dr. Goldfarb said. “When I did my residency, I really liked almost every one of my rotations, but I had a special affinity for working with kids. And I’ve really been able to marry the hand work and the kids part. For a long time, my practice was mainly hand surgery, and I did some work with kids. Now it really leans strongly toward pediatric orthopedics and congenital hand surgery, though I still do treat some adults.”
Dr. Goldfarb also treats patients at Shriners Hospitals for Children-St. Louis. It was at Shriners that he and Dr. Manske treated the child who still ranks as his most unusual case.
“He was from Central America, and he was born with three arms,” Dr. Goldfarb recalled. “We were able to surgically combine two minimally functional arms and make them into a pretty good functional arm. It was an operation that never had been done before for a condition that never had been reported before. That young man still comes back and forth from Central America for follow-up appointments, and it’s been really neat to watch him grow.”
USING 3-D PRINTERS
With that child from Central America, Dr. Goldfarb was able to help build a functioning, biological arm. But that’s not always possible. Birth differences and traumatic injuries mean a number of his patients need prostheses instead.
“Prostheses are heavy, and they’re expensive,” he said. “It used to be that we would force kids, at six months of age, to wear them, and the reality was that we could require that for a few minutes, but they would abandon them pretty quickly.”
Then, a few years ago, a team of undergraduates at Washington University began working on a senior project in biomedical engineering, and they contacted Dr. Goldfarb about building a prosthesis with a 3-D printer. They worked together to make a lightweight, powered prosthesis with fingers that move. Such devices also can be printed in bright colors.
“The concept that a prosthesis should look as natural as possible has been flipped on its head,” he said. “Instead of trying to hide the birth difference a kid may have, these new 3-D-printed prostheses almost say ‘Look at me!’ Although it’s not quite ready for prime time, using these 3-D printers to make prostheses is advancing at a rapid speed.”
Dr. Goldfarb and his wife, Talia, have three children ranging in age from 12 to 18. Whether one or more of them will follow their father and grandfather into medicine isn’t yet clear. He’d be pleased if any of them decide to pursue medicine, as long as they are happy in the choice—just as his father was pleased one of his kids decided to go into medicine.
For more information or to refer a patient, call Children’s Direct at 800.678.HELP (4357).