CHAPTER 30
|
The Child with a Limb Deficiency
1533
TABLE 30.3
Boys: 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
21
1
14.48
0.628
0.077
15.74
15.11
13.85
13.22
57
2
18.15
0.874
0.107
19.90
19.02
17.28
16.40
65
3
21.09
1.031
0.126
23.15
22.12
20.06
19.03
66
4
23.65
1.197
0.146
26.04
24.85
22.45
21.26
66
5
25.92
1.342
0.164
28.60
27.26
24.58
23.24
67
6
28.09
1.506
0.184
31.10
29.60
25.58
25.08
67
7
30.25
1.682
0.205
33.61
31.93
28.57
26.89
67
8
32.28
1.807
0.221
35.89
34.09
30.47
28.67
67
9
34.36
1.933
0.236
38.23
36.29
32.43
30.49
67
10
36.29
2.057
0.251
40.40
38.35
34.23
32.18
67
11
38.16
2.237
0.276
42.63
40.40
35.92
33.69
67
12
40.12
2.447
0.299
45.01
42.57
37.67
35.23
67
13
42.17
2.765
0.338
47.70
44.95
39.40
36.64
67
14
44.18
2.809
0.343
49.80
46.99
41.37
38.56
67
15
45.69
2.512
0.307
50.71
48.20
43.19
40.67
67
16
46.66
2.244
0.274
51.15
48.90
44.42
42.17
67
17
47.07
2.051
0.251
51.17
49.12
45.02
42.97
67
18
47.23
1.958
0.239
51.15
49.19
45.27
48.31
Tibia
Distribution
Number
Age (yr)
Mean
s
d
s
m
+2
s
d
+1
s
d
−1
s
d
−2
s
d
61
1
11.60
0.620
0.074
12.84
12.22
10.98
10.36
67
2
14.54
0.809
0.099
16.16
15.35
13.73
12.92
67
3
16.79
0.935
0.114
18.66
17.72
15.86
14.92
67
4
18.67
1.091
0.133
20.85
19.76
17.58
16.49
67
5
20.46
1.247
0.152
22.95
21.71
19.21
17.97
67
6
22.12
1.418
0.173
24.96
23.54
20.87
19.46
67
7
23.76
1.632
0.199
27.02
25.39
22.13
20.50
67
8
25.38
1.778
0.217
28.94
27.16
23.60
21.82
67
9
26.99
1.961
0.240
30.91
28.95
25.02
23.06
67
10
28.53
2.113
0.258
32.76
30.64
26.42
24.30
67
11
30.10
2.301
0.281
34.70
32.40
27.80
25.50
67
12
31.75
2.536
0.310
36.82
34.29
29.21
26.68
67
13
33.49
2.833
0.345
39.16
36.32
30.66
27.82
67
14
35.18
2.865
0.350
40.91
38.04
32.32
29.45
67
15
36.38
2.616
0.320
41.61
39.00
33.76
31.15
67
16
37.04
2.412
0.295
41.86
39.45
34.63
32.22
67
17
37.22
2.316
0.283
41.85
39.54
34.00
32.59
67
18
37.29
2.254
0.275
41.80
39.54
35.04
32.78
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.
better than the use of biologic material (45, 46). Marquardt
reported in the mid-1970s, in the German literature, on the
capping of the bone end with a cartilage–bone graft. More
recently, Tenholder et al. (47) reported comparable results with
the use of a polytetrafluoroethylene felt pad. Various reports
for both acquired and congenital amputees indicate generally
favorable results, with most revisions being for technical rea-
sons (45, 46, 48, 49).
When a patient presents with pain and bursa forma-
tion, prosthetic modification and other conservative measures
