Surgical management of juvenile amputation overgrowth with a synthetic cap

Seventeen amputations (in 14 children) with established overgrowth were treated by capping of the residual limb with a polytetrafluoroethylene (PTFE) felt pad. Average age at the time of the procedure was 7 years 10 months. Mean follow-up was 4 years 9 months. Statistical comparisons were made to historical controls, treated by resection revision or biologic capping, from a prior overgrowth study from the authors' institution. Revision surgery was necessary in 86% of resection revisions, 29% of biologic caps, and 29% of PTFE caps. Kaplan-Meier analysis estimated survival times of 3 years 3 months for resection revision, 6 years 1 month for biologic caps, and 7 years 2 months for PTFE caps. PTFE and biologic caps were both statistically better than resection revision with regard to need for subsequent operation and survivorship, but were not statistically different from each other. Complications associated with PTFE capping and biologic capping were distinct.