1532
CHAPTER 30
|
The Child with a Limb Deficiency
TABLE 30.2
Girls: Lengths of the Long Bones Including epiphyses
a
Femur
Distribution
Number
Age (yr)
Mean
s
d
s
m
+2
s
d
+1
s
d
−1
s
d
−2
s
d
30
1
14.81
0.673
0.082
16.16
15.48
14.14
13.46
52
2
18.23
0.888
0.109
20.01
19.12
17.34
16.45
63
3
21.29
1.100
0.134
23.49
22.39
20.19
19.09
66
4
23.92
1.339
0.164
26.60
25.26
22.58
21.24
66
5
26.32
1.437
0.176
29.19
27.76
24.88
23.45
66
6
28.52
1.616
0.197
31.75
30.14
26.90
25.29
67
7
30.60
1.827
0.223
34.25
32.43
28.77
26.95
67
8
32.72
1.930
0.236
36.59
34.66
30.78
28.85
67
9
34.71
2.117
0.259
38.94
36.83
32.59
30.48
67
10
36.72
2.300
0.281
41.32
39.02
34.42
32.12
67
11
38.81
2.468
0.302
43.75
41.28
36.34
33.87
67
12
40.74
2.507
0.306
45.75
43.25
38.23
35.73
67
13
42.31
2.428
0.310
47.17
44.74
39.88
37.45
67
14
43.14
2.269
0.277
47.68
45.41
40.87
38.60
67
15
43.47
2.197
0.277
47.86
45.67
41.27
39.08
67
16
43.58
2.193
0.268
47.97
45.77
41.39
39.19
67
17
43.60
2.192
0.268
47.98
45.79
41.41
39.22
67
18
43.63
2.195
0.269
48.02
45.82
41.44
39.24
Tibia
Distribution
Number
Age (yr)
Mean
s
d
s
m
+2
s
d
+1
s
d
−1
s
d
−2
s
d
61
1
11.57
0.646
0.082
12.86
12.22
10.92
10.28
67
2
14.51
0.739
0.090
15.99
15.25
13.77
13.03
67
3
16.81
0.893
0.109
18.00
17.70
15.92
15.02
67
4
18.86
1.144
0.140
21.15
20.00
17.72
16.57
67
5
20.77
1.300
0.159
23.37
22.07
19.47
18.17
67
6
22.53
1.458
0.178
25.45
23.99
21.07
19.61
67
7
24.22
1.640
0.200
27.50
25.86
22.58
20.94
67
8
25.89
1.786
0.218
29.46
27.68
24.10
22.32
67
9
27.56
1.993
0.243
31.55
29.55
25.57
23.57
67
10
29.28
2.193
0.259
33.67
31.47
27.09
24.89
67
11
31.00
2.384
0.291
35.77
33.38
28.62
26.23
67
12
32.61
2.424
0.296
37.46
35.03
30.19
27.76
67
13
33.83
2.374
0.290
38.58
36.20
31.46
29.08
67
14
34.43
2.228
0.272
38.89
36.66
32.20
29.97
67
15
34.59
2.173
0.265
38.94
36.76
32.42
30.24
67
16
34.63
2.151
0.263
38.93
36.78
32.48
30.33
67
17
34.65
2.158
0.264
38.97
36.81
32.49
30.33
67
18
34.65
2.161
0.264
38.97
36.81
32.49
30.33
a
Orthoradiographic measurements from longitudinal series of 67 children.
From Anderson M, Messner MB, Green WT. Distribution of lengths of the normal femur and tibia in children from one to eighteen years of age. J Bone Joint Surg Am
1964;46:1197, with permission.
Routine evaluation can detect the problem before it is painful,
and surgical correction is fairly straightforward at this point.
Prosthetic adjustments may help delay surgical revision, but
will seldom be sufficient with significant overgrowth.
Treatment of overgrowth has included implantation of
various plastic and metallic devices over the end of the bone
(the so-called stump-capping procedures). However, these
techniques are not commonly used because the results are no
