Iliac crest apophysis transfer to treat stump overgrowth after limb amputation in children: case series and literature review
- 102 Downloads
Stump overgrowth is the main problem of limb amputation in children. Many surgical procedures have been developed to overcome the problem, but all have shown inconsistent results. The only surgical procedure that has been successful in preventing overgrowth is capping of the amputated limb with a cartilaginous cap taken from the amputated limb, usually from the head of fibula. A donor site is not available in revision cases. Iliac crest apophysis transfer was suggested to treat the condition, but has never been previously reported. The purpose of this study is to review the results of iliac crest apophysis transfer to prevent stump overgrowth.
Five children with amputation stump overgrowth underwent iliac apophyseal transfer to cap the resection site of the overgrowth.
Retrospective review showed that three of the five suffered recurrent stump overgrowth two to four years after the index surgery. All three were revised again. One patient was lost to follow-up.
Although many studies showed capping of the stump with cartilaginous cap to be successful in preventing stump overgrowth, iliac crest apophysis transfer was only successful in one of four cases available to follow-up (25%). This is not a reliable enough method to be used routinely.
KeywordsChildren amputation Stump overgrowth Marquardt Iliac crest bone grafting
This research received no specific fund.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
For this type of study formal consent is not required.
- 7.Hugh GW, Setoguchi Y (1992) Marquardt stump capping for overgrowth. JACPOC 27:61Google Scholar
- 9.Pfeil J, Marquardt E, Holtz T, Niethard FU, Schneider E, Carstens C (1991) The stump capping procedure to prevent or treat terminal osseous overgrowth. Prosthetics Orthot Int 15(2):96–99Google Scholar
- 10.Pellicore RJ, Sciora J, Lambert CN, Hamilton RC (1974) Incidence of bone overgrowth in the juvenile amputee population. Inter Clinic Information Bulletin 13:1–10Google Scholar
- 11.Saal FV (1939) Epiphysiodesis combined with amputation. J Bone Joint Surg 21:442Google Scholar
- 12.Swanson AB (1972) Silicone-rubber implants to control the overgrowth phenomenon in the juvenile amputee. Inter Clinic Info Bull 11:5–8Google Scholar
- 13.Aitken GT (1962) Overgrowth of the amputation stump. Inter Clinic Information Bulletin 1:1–8Google Scholar
- 15.Speer DP (1981) The pathogenesis of amputation stump overgrowth. Clin Orthop Relat Res 159:294–307Google Scholar
- 16.Swanson AB (1969) Bone overgrowth in the juvenile amputee and its control by the use of silicone rubber implants. Inter Clinic Information Bulletin 8:9–18Google Scholar
- 18.Wang GJ, Baugher WH, Stamp WG (1978) Epiphyseal transplant in amputations. Effects on overgrowth in a rabbit model. Clin Orthop Relat Res 130:285–288Google Scholar
- 19.Fedorak GT, Watts HG, Cuomo AV, Ballesteros JP, Grant HJ, Bowen RE, Scaduto AA (2015) Osteocartilaginous transfer of the proximal part of the fibula for osseous overgrowth in children with congenital or acquired tibial amputation: surgical technique and results. J Bone Jt Surg Am 1(97(7)):574–581CrossRefGoogle Scholar