Postoperative alopecia in children after orthopaedic surgery
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Published on: December 5, 2025
Christopher Lee1, Paul D Choi, Gary Scott
1Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
Insights
Postoperative alopecia, a rare hair loss complication, can occur in children after orthopedic surgery. This condition is typically self-limiting, with hair regrowth observed within 8-12 weeks post-procedure.
Area of Science:
- Pediatric Orthopaedic Surgery
- Dermatology
- Surgical Complications
Background:
- Investigating the incidence and characteristics of postoperative alopecia in pediatric patients undergoing orthopedic procedures.
- Highlighting the need to recognize this uncommon complication in a Level I trauma center setting.
Observation:
- Three pediatric patients (2 female, 1 male, average age 13.7 years) developed alopecia post-orthopedic surgery.
- Alopecia presented 2-3 weeks after procedures like femoral osteotomies and tibia pseudarthrosis repair, with no significant intraoperative complications.
- Two patients had obesity as a comorbidity; none had significant past medical history.
Findings:
- Hair loss was localized to the posterior scalp in all affected children.
- Complete hair regrowth occurred in one patient, while two showed ongoing regrowth within 8-12 weeks.
- No intraoperative hypotension or hypothermia was recorded, suggesting other etiological factors.
Implications:
- Postoperative alopecia is an uncommon yet recognized complication in pediatric orthopaedic surgery.
- Awareness among clinicians is crucial for proper diagnosis and management of this usually self-limited condition.
- Recommendations include considering head padding during prolonged orthopedic surgeries to potentially mitigate risk.
Background:
To report the cases of postoperative alopecia encountered after orthopaedic surgery at a single-level I trauma pediatric hospital.
Methods:
We report on 3 children who developed postoperative alopecia after an orthopaedic surgery. The chart review included demographics and independent variables including age, ethnicity, weight, sex, presence of coexisting medical conditions, type and duration of surgery performed, examination findings at presentation and diagnosis of alopecia, and outcomes were recorded. Inpatient and outpatient clinic notes, operative reports, and recorded vital signs were also reviewed.
Results:
Three children (2 female, 1 male) were noted to develop postoperative alopecia. The average age at surgery was 13.7 years (range, 12 to 16). There was no significant past medical history, and 2 of 3 patients had obesity as a comorbidity. The type of surgery included: 2 proximal femoral osteotomies with proximal femoral osteoplasties and 1 wide resection of a congenital tibia pseudarthrosis with contralateral vascularized fibular grafting and internal fixation. Mean surgical duration was 5.9 hours (range, 4.4 to 7.1), and no intraoperative episodes of hypotension (<50 mm Hg) or hypothermia (T<35.9°C) occurred. The patients presented 2 to 3 weeks after surgery with hair loss localized over the posterior portion of the head. All patients were noted to have hair regrowth within 8 to 12 weeks, with 1 patient fully recovered and 2 patients continuing hair regrowth at most recent follow-up.
Conclusions:
Postoperative alopecia is an uncommon but usually self-limited complication that can occur in children undergoing orthopaedic surgery. Although rare, the treating physician should be aware of its occurrence and course, and appropriate padding of the head during surgery is advised.
Level Of Evidence:
Level IV--retrospective case series.
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