Lower-limb deficiencies and amputations in children.

Research output: Contribution to journalReview article

26 Scopus citations

Abstract

Important differences exist in the management of child and adult amputees. Many factors, including the etiology of childhood limb deficiencies, expected skeletal growth, functional demand on the locomotor system and prosthesis, appositional bone stump overgrowth, and psychological challenges, make caring for these young patients particularly challenging. Adherence to the general principles of childhood amputation surgery will typically guide one to the optimal functional result. These principles can be summarized as follows: (1) Preserve length. (2) Preserve important growth plates. (3) Perform disarticulation rather than transosseous amputation whenever possible. (4) Preserve the knee joint whenever possible. (5) Stabilize and normalize the proximal portion of the limb. (6) Be prepared to deal with issues in addition to limb deficiency in children with other clinically important conditions. A large proportion of young amputees undergo a Syme disarticulation, modified Boyd amputation, or knee disarticulation. A modified Van Nes rotationplasty procedure is also useful in this age group. All these provide the child with a weight-bearing stump with good growth potential and no complications due to bone overgrowth. Appropriate timing of amputation procedures and prosthetic fittings is essential to maximize functional benefit to the patient.

Original languageEnglish (US)
Pages (from-to)358-367
Number of pages10
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume6
Issue number6
DOIs
StatePublished - Jan 1 1998

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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