CHAPTER 30
|
The Child with a Limb Deficiency
1577
A
B
C
FIGURE 30-44.
This child with congenital bilateral hip
disarticulation and transhumeral amputations
(A)
was fit-
ted with four prostheses
(B)
, which she quickly abandoned
in favor of her power chair and simple assistive devices
(C)
.
Pearls and Pitfalls.
Children with bilateral amelia will
depend on their lower extremities for all of their ADL. It
is important to refrain from any lower extremity surgery
until the full extent of lower extremity use is understood. It
is especially important to avoid any lower extremity ampu-
tation in these children if it interferes with their ADL.
Also, special considerations for treating spinal deformity in
these patients are warranted. Because spinal flexibility may
assist in allowing the lower extremities to substitute for the
upper extremities, preservation of spinal motion is a spe-
cial concern. If spinal fusion is necessary, limited fusion is
indicated.
