Advertisement

Limb Deficiencies

  • Anna D. VergunEmail author
  • Hugh G. Watts
Chapter

Abstract

Limb deficiencies can result in functional disability and are often associated with significant social stigmas. Surgeons treating these conditions in resource-rich countries work in a team that includes prosthetists, physical and occupational therapists, and social workers. In places with limited resources, failure to appreciate the limitations imposed by the absence of such professionals, or deficiencies in their skills, can result in a lack of functional improvement and unnecessary use of resources. Treatment must be individualized and tailored to personal or cultural beliefs. The purpose of this chapter is to equip the surgeon with some basic principles to guide management of limb-deficient children in a variety of circumstances.

References

  1. 1.
    Anderson M, Green WT, Messner MB. Growth and prediction of growth in the lower extremities. J Bone Joint Surg Am. 1963;45:1.CrossRefGoogle Scholar
  2. 2.
    Anderson M, Messner M, Green W. Distribution of the normal femur and tibia in children from one to eighteen years of age. J Bone Joint Surg. 1964;46A:1197–202.CrossRefGoogle Scholar
  3. 3.
    Paley D, Bhave A, Herzenberg J, Bowen R. Multiplier method for predicting limb-length discrepancy. J Bone Joint Surg. 2000;82:1432–46.CrossRefGoogle Scholar
  4. 4.
    Menelaus M. Correction of leg length discrepancy by epiphyseal arrest. J Bone Joint Surg. 1966;48B:336–9.CrossRefGoogle Scholar
  5. 5.
    Westh R, Menelaus M. A simple calculation for the timing of epiphyseal arrest: a further report. J Bone Joint Surg. 1981;63B:117–9.CrossRefGoogle Scholar
  6. 6.
    Martini AK, Marquardt E. Stump plasty on congenital amputations. Garyounis Med J. 1980;3(Suppl):83–6.Google Scholar
  7. 7.
    Fedorak GT, Watts HG, Cuomo AV, Ballesteros JP, Grant HJ, Bowen RE, Scaduto AA. 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 Joint Surg Am. 2015;97(7):574–81.CrossRefGoogle Scholar
  8. 8.
    Swanson AB, Swanson GD. The Krukenberg procedure in the juvenile amputee. Clin Orthop. 1980;148:55.Google Scholar

Internet Resources for Limb Deficiency and Loss

  1. For care providers: http://www.acpoc.org/.
  2. The Association of Children’s Prosthetic-Orthotic Clinics provides a comprehensive resource of treatment options.Google Scholar
  3. This site provides education, support and advocacy.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of OrthopedicsUniversity of North CarolinaChapel HillUSA
  2. 2.Shriners Hospital for ChildrenPasadenaUSA

Personalised recommendations