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Problems with excessive residual lower leg length in pediatric amputees
W R Osebold1, E L Lester, D M Christenson
1Shriners Hospital for Children, Spokane, Washington 99210-2472, USA.
The Iowa Orthopaedic Journal
|January 30, 2002
Summary
Pediatric amputees with long below-knee limbs often need specialized prosthetics. Surgical lengthening of the residual limb (epiphyseodesis) can enable fitting of advanced, dynamic-response prosthetic feet.
Area of Science:
- Orthopedic surgery
- Prosthetics and orthotics
- Pediatric rehabilitation
Background:
- Children with below-knee amputations often have long residual limbs.
- This length can limit prosthetic options, particularly for dynamic-response feet.
Observation:
- Six pediatric amputees (ages 9 months to 5 years) with long below-knee residual limbs were studied.
- Existing limb length restricted prosthetic choices to low-profile devices.
- Three patients underwent tibial-fibular epiphyseodesis to lengthen the residual limb.
Findings:
- Epiphyseodesis created adequate distal limb length for fitting larger, more dynamic-response prosthetic feet in skeletally immature patients.
- Scanogram data suggest successful lengthening will be maintained at skeletal maturity.
- Two other families are considering epiphyseodesis; one patient is skeletally mature and not a candidate.
Implications:
- Surgical limb lengthening via epiphyseodesis is a viable strategy for improving prosthetic options in pediatric amputees with long residual limbs.
- This intervention can enhance functional outcomes and quality of life by allowing the use of advanced prosthetic technology.
- Further research should evaluate long-term functional benefits and patient satisfaction with dynamic-response prosthetics post-epiphyseodesis.