Successful replantation of the leg in a pre-ambulatory infant

Area of Science:

• Pediatric Orthopedics
• Reconstructive Surgery
• Traumatology

Background:

• Limb replantation in infants presents unique challenges due to rapid growth and developmental plasticity.
• Below-knee amputations in very young children require specialized surgical approaches to optimize long-term function.

Purpose of the Study:

• To document the long-term functional outcomes of a below-knee amputation replantation in a 7-month-old infant.
• To evaluate the potential for spontaneous correction of limb length discrepancy in pediatric replantation.
• To highlight the benefits of early intervention in pediatric limb trauma.

Main Methods:

• Successful surgical replantation of a traumatically amputated below-knee limb in a 7-month-old infant.
• Long-term clinical follow-up over seven years, assessing range of motion, sensation, and functional mobility.
• Radiographic evaluation of limb length discrepancy.

Main Results:

• The child demonstrates excellent ankle and knee range of motion and regained plantar sensation.
• The patient can walk, run, and jump without assistive devices.
• A 5.5 cm leg-length discrepancy is present but expected to improve with future bone overgrowth.

Conclusions:

• Early below-knee replantation in infancy can lead to excellent functional recovery and near-normal gait.
• The plasticity of the pediatric central nervous system and skeletal system supports successful long-term outcomes.
• This case underscores the viability of limb replantation in very young children, even prior to ambulation.