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Assessment of patient function after limb-sparing surgery
R A Frieden1, D Ryniker, S Kenan
1Department of Rehabilitation Medicine, Mount Sinai Medical Center, Mount Sinai School of Medicine, New York, NY 10029.
Archives of Physical Medicine and Rehabilitation
|January 1, 1993
Summary
Children undergoing limb-sparing surgery for bone tumors have unique rehabilitation needs. Early mobilization and gait training are key, with most patients achieving good mobility post-surgery.
Area of Science:
- Physiatry
- Pediatric Oncology
- Orthopedic Surgery
Background:
- Cancer rehabilitation is increasingly important in physiatry.
- Growing longevity and treatment side effects necessitate specialized care.
- Limb-sparing procedures are an alternative to amputation for pediatric bone tumors.
Purpose of the Study:
- To investigate the specific rehabilitation needs of children treated with limb-sparing surgery for primary bone tumors.
- To evaluate the effectiveness of physical therapy interventions in this patient population.
Main Methods:
- Retrospective chart analysis of 17 pediatric patients.
- Patients underwent resection and expandable endoprosthetic replacement for primary bone tumors.
- Follow-up averaged 2.5 years, including inpatient and outpatient physical therapy.
Main Results:
- Gait training was generally straightforward.
- Seven patients required no assistive devices; ten used knee orthoses or crutches.
- Shoe lifts compensated for limb length discrepancy prior to implant lengthening.
- Outcomes compared favorably to high proximal amputees requiring external prostheses.
Conclusions:
- Children undergoing limb-sparing surgery have distinct rehabilitation requirements.
- Early mobilization, gait training, and managing lengthening procedures are crucial.
- Continued follow-up is essential to monitor activity restrictions and long-term outcomes.