Pediatric Limb Deficiencies

Question 1

What is terminal overgrowth

Answer 1

Spiking

Question 2

Body powered prosthesis UE

Answer 2

As young as one, once kid can do it

Question 3

K4 amputation level

Answer 3

The patient has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress, or energy levels. (Child, active adult, or athlete.)

Question 4

What is more common, upper or lower, pediatric amputations

Answer 4

Upper 3x Lower

Question 5

Disarticulation or transdiaphyseal for kids

Answer 5

Disarticulation

Question 6

Is phantom pain common in kids

Answer 6

No

Question 7

Why disarticulation

Answer 7

Because it preserves ability for limb to grow

Question 8

Which amputations, upper or lower, are most associated with other anomolies

Answer 8

Upper – esp related to craniofacial, cardiac, and hematologic (due to the chronology of 1st trimester)

Question 9

Most common pediatric amputation problem

Answer 9

The most common complication in a skeletally immature child is bony overgrowth, or spiking. Bony overgrowth can occur in 40% of children5 and is usually in children with amputations acquired before the age of twelve.

Question 10

K0 amputation level

Answer 10

The patient does not have the ability or potential to ambulate or transfer safely with or without assistance, and a prosthesis does not enhance quality of life or mobility

Question 11

Where does amputation overgrowth most commonly occur

Answer 11

Overgrowth most commonly occurs in the humerus, followed by fibula, tibia, and femur.

Question 12

How many kids with limb deficiencies will have other anomalies

Answer 12

8/10

Question 13

K2 amputation level

Answer 13

The patient has the ability or potential for ambulation with the ability to traverse low-level environmental barriers, such as curbs, stairs, or uneven surfaces. (Limited community ambulator.)

Question 14

Active terminal device

Answer 14

1 year, when can walk

Question 15

Timing of lower prosthetic

Answer 15

Solid ankle cushion heel (SACH), infancy

Question 16

K1 amputation level

Answer 16

The patient has the ability or potential to use a prosthesis for transfer or ambulation on level surfaces at fixed cadence. (Limited and unlimited household ambulator.)

Question 17

When do you fit with prosthesis for lower limb

Answer 17

When ready to pull to stand, 9-10 months

Question 18

What is common if amputations goes wrong

Answer 18

Terminal bony overgrowth

Question 19

Knee joint

Answer 19

2-3

Question 20

Timing of upper extremity prosthesis

Answer 20

Used to be six months, can sit and do bimanual. But now can be 3 to 6 months

Question 21

Energy strong releasing feet

Answer 21

Toddler

Question 22

Myoelectric

Answer 22

2

Question 23

Rules of surgical management of amputations in kids

Answer 23

1. Preserve length
2. Preserve growth plates
3. Perform disarticulation instead of transosseous
4. Preserve knee joint
5. Stabilize and normalize proximal portions

Question 24

Which trimester is most important for embryogenesis of limb deficiencies

Answer 24

1st due to mesodermal formation of the limb at 26 days gestations until 8 weeks

Question 25

Passive UE device

Answer 25

6 months classically when kid can sit

Question 26

K3 amputation level

Answer 26

The patient has the ability or potential for ambulation with variable cadence. Community ambulator who has the ability to navigate most environmental barriers.