|
|
char = A;code = 65
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char = s;code = 115
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char = u;code = 117
char = m;code = 109
char = p;code = 112
char = s;code = 115
char = .;code = 46
result sql = Angular deformity in pediatric transtibial amputation stumps.
Angular deformity in pediatric transtibial amputation stumps.char = <;code = 60
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char = I;code = 73
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char = C;code = 67
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char = .;code = 46
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char = A;code = 65
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char = <;code = 60
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char = H;code = 72
char = O;code = 79
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char = S;code = 83
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result sql = INTRODUCTION : Progressive angular deformity after surgical transtibial amputation in the pediatric population has not been described in the literature. Angular deformity in amputation stumps may lead to problems with pain and fitting of the prosthesis. The aim of this study was to evaluate the incidence and pattern of angular deformity and its treatment.
METHODS : A retrospective review of 21 patients (24 limbs) with transtibial amputation was carried out. The mean age was 7.4 years (range: 1 to 18). There were 8 congenital and 13 acquired amputations (7 trauma, 4 infection, 1 tumor, 1 vascular). Sequential radiographs were evaluated for frontal and sagittal plane alignment. Deformity was defined as an angular deviation greater than 5 degrees.
RESULTS : Angular deformity was identified in 8 (38%) patients. Two patients had valgus deformity, 2 had varus deformity, and 1 had isolated recurvatum deformity. One patient had valgus procurvatum and 1 patient had varus recurvatum deformity. There was a mean stump revision rate of 1.38 in the congenital group and 0.85 in the acquired group. Three patients underwent deformity correction using an external fixator owing to difficulty with prosthetic fitting. All patients experienced improved fitting of their prosthesis after surgery.
CONCLUSIONS : Angular deformity can arise in children with transtibial amputations and may influence prosthesis fit and gait. Clinical and radiographic surveillance is important, and surgical correction may be of benefit. Surprisingly, stump revision rate was similar in both groups.
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result sql = Angular deformity in pediatric transtibial amputation stumps.
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char = ;code = 32
char = a;code = 97
char = f;code = 102
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = s;code = 115
char = u;code = 117
char = r;code = 114
char = g;code = 103
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = u;code = 117
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = e;code = 101
char = d;code = 100
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = p;code = 112
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = n;code = 110
char = o;code = 111
char = t;code = 116
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = r;code = 114
char = i;code = 105
char = b;code = 98
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = l;code = 108
char = i;code = 105
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = .;code = 46
char = ;code = 32
char = A;code = 65
char = n;code = 110
char = g;code = 103
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = u;code = 117
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = u;code = 117
char = m;code = 109
char = p;code = 112
char = s;code = 115
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = y;code = 121
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = a;code = 97
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = b;code = 98
char = l;code = 108
char = e;code = 101
char = m;code = 109
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = f;code = 102
char = i;code = 105
char = t;code = 116
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = i;code = 105
char = m;code = 109
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = u;code = 117
char = d;code = 100
char = y;code = 121
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = e;code = 101
char = v;code = 118
char = a;code = 97
char = l;code = 108
char = u;code = 117
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = g;code = 103
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = M;code = 77
char = E;code = 69
char = T;code = 84
char = H;code = 72
char = O;code = 79
char = D;code = 68
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = A;code = 65
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = t;code = 116
char = r;code = 114
char = o;code = 111
char = s;code = 115
char = p;code = 112
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = v;code = 118
char = i;code = 105
char = e;code = 101
char = w;code = 119
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 2;code = 50
char = 1;code = 49
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 2;code = 50
char = 4;code = 52
char = ;code = 32
char = l;code = 108
char = i;code = 105
char = m;code = 109
char = b;code = 98
char = s;code = 115
char = );code = 41
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = u;code = 117
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = r;code = 114
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = 7;code = 55
char = .;code = 46
char = 4;code = 52
char = ;code = 32
char = y;code = 121
char = e;code = 101
char = a;code = 97
char = r;code = 114
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = g;code = 103
char = e;code = 101
char = :;code = 58
char = ;code = 32
char = 1;code = 49
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = 1;code = 49
char = 8;code = 56
char = );code = 41
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = 8;code = 56
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = g;code = 103
char = e;code = 101
char = n;code = 110
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 1;code = 49
char = 3;code = 51
char = ;code = 32
char = a;code = 97
char = c;code = 99
char = q;code = 113
char = u;code = 117
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = u;code = 117
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 7;code = 55
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = u;code = 117
char = m;code = 109
char = a;code = 97
char = ,;code = 44
char = ;code = 32
char = 4;code = 52
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = f;code = 102
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ,;code = 44
char = ;code = 32
char = 1;code = 49
char = ;code = 32
char = t;code = 116
char = u;code = 117
char = m;code = 109
char = o;code = 111
char = r;code = 114
char = ,;code = 44
char = ;code = 32
char = 1;code = 49
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = s;code = 115
char = c;code = 99
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = );code = 41
char = .;code = 46
char = ;code = 32
char = S;code = 83
char = e;code = 101
char = q;code = 113
char = u;code = 117
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = r;code = 114
char = a;code = 97
char = d;code = 100
char = i;code = 105
char = o;code = 111
char = g;code = 103
char = r;code = 114
char = a;code = 97
char = p;code = 112
char = h;code = 104
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = e;code = 101
char = v;code = 118
char = a;code = 97
char = l;code = 108
char = u;code = 117
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = s;code = 115
char = a;code = 97
char = g;code = 103
char = i;code = 105
char = t;code = 116
char = t;code = 116
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = p;code = 112
char = l;code = 108
char = a;code = 97
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = i;code = 105
char = g;code = 103
char = n;code = 110
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = .;code = 46
char = ;code = 32
char = D;code = 68
char = e;code = 101
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = f;code = 102
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = a;code = 97
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char = g;code = 103
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = r;code = 114
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char = d;code = 100
char = e;code = 101
char = v;code = 118
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = g;code = 103
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = a;code = 97
char = n;code = 110
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char = 5;code = 53
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = g;code = 103
char = r;code = 114
char = e;code = 101
char = e;code = 101
char = s;code = 115
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = R;code = 82
char = E;code = 69
char = S;code = 83
char = U;code = 85
char = L;code = 76
char = T;code = 84
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = A;code = 65
char = n;code = 110
char = g;code = 103
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = f;code = 102
char = i;code = 105
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 8;code = 56
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = w;code = 119
char = o;code = 111
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = d;code = 100
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = l;code = 108
char = g;code = 103
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ,;code = 44
char = ;code = 32
char = 2;code = 50
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = d;code = 100
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 1;code = 49
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = s;code = 115
char = o;code = 111
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = u;code = 117
char = r;code = 114
char = v;code = 118
char = a;code = 97
char = t;code = 116
char = u;code = 117
char = m;code = 109
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = .;code = 46
char = ;code = 32
char = O;code = 79
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = d;code = 100
char = ;code = 32
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char = r;code = 114
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char = t;code = 116
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char = i;code = 105
char = n;code = 110
char = g;code = 103
char = l;code = 108
char = y;code = 121
char = ,;code = 44
char = ;code = 32
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char = t;code = 116
char = u;code = 117
char = m;code = 109
char = p;code = 112
char = ;code = 32
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char = e;code = 101
char = v;code = 118
char = i;code = 105
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = ;code = 32
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char = a;code = 97
char = s;code = 115
char = ;code = 32
char = s;code = 115
char = i;code = 105
char = m;code = 109
char = i;code = 105
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = b;code = 98
char = o;code = 111
char = t;code = 116
char = h;code = 104
char = ;code = 32
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result sql = INTRODUCTION : Progressive angular deformity after surgical transtibial amputation in the pediatric population has not been described in the literature. Angular deformity in amputation stumps may lead to problems with pain and fitting of the prosthesis. The aim of this study was to evaluate the incidence and pattern of angular deformity and its treatment.
METHODS : A retrospective review of 21 patients (24 limbs) with transtibial amputation was carried out. The mean age was 7.4 years (range: 1 to 18). There were 8 congenital and 13 acquired amputations (7 trauma, 4 infection, 1 tumor, 1 vascular). Sequential radiographs were evaluated for frontal and sagittal plane alignment. Deformity was defined as an angular deviation greater than 5 degrees.
RESULTS : Angular deformity was identified in 8 (38%) patients. Two patients had valgus deformity, 2 had varus deformity, and 1 had isolated recurvatum deformity. One patient had valgus procurvatum and 1 patient had varus recurvatum deformity. There was a mean stump revision rate of 1.38 in the congenital group and 0.85 in the acquired group. Three patients underwent deformity correction using an external fixator owing to difficulty with prosthetic fitting. All patients experienced improved fitting of their prosthesis after surgery.
CONCLUSIONS : Angular deformity can arise in children with transtibial amputations and may influence prosthesis fit and gait. Clinical and radiographic surveillance is important, and surgical correction may be of benefit. Surprisingly, stump revision rate was similar in both groups.
Publication: J Pediatr Orthop 2009 Oct-Nov ;29(7)::726-9. :doi: 10.1097/BPO.0b013e3181b726e1.
Publication Date: 2009 Oct-Nov
Study Author(s): Ranade, Ashish;McCarthy, James J;Davidson, Richard S;
Institution: Shriners Hospitals for Children, Philadelphia, PA, USA.
Shortcut link to this study:
Publication Date: 2009 Oct-Nov
Study Author(s): Ranade, Ashish;McCarthy, James J;Davidson, Richard S;
Institution: Shriners Hospitals for Children, Philadelphia, PA, USA.
Shortcut link to this study:
INTRODUCTION : Progressive angular deformity after surgical transtibial amputation in the pediatric population has not been described in the literature. Angular deformity in amputation stumps may lead to problems with pain and fitting of the prosthesis. The aim of this study was to evaluate the incidence and pattern of angular deformity and its treatment.
METHODS : A retrospective review of 21 patients (24 limbs) with transtibial amputation was carried out. The mean age was 7.4 years (range: 1 to 18). There were 8 congenital and 13 acquired amputations (7 trauma, 4 infection, 1 tumor, 1 vascular). Sequential radiographs were evaluated for frontal and sagittal plane alignment. Deformity was defined as an angular deviation greater than 5 degrees.
RESULTS : Angular deformity was identified in 8 (38%) patients. Two patients had valgus deformity, 2 had varus deformity, and 1 had isolated recurvatum deformity. One patient had valgus procurvatum and 1 patient had varus recurvatum deformity. There was a mean stump revision rate of 1.38 in the congenital group and 0.85 in the acquired group. Three patients underwent deformity correction using an external fixator owing to difficulty with prosthetic fitting. All patients experienced improved fitting of their prosthesis after surgery.
CONCLUSIONS : Angular deformity can arise in children with transtibial amputations and may influence prosthesis fit and gait. Clinical and radiographic surveillance is important, and surgical correction may be of benefit. Surprisingly, stump revision rate was similar in both groups.
METHODS : A retrospective review of 21 patients (24 limbs) with transtibial amputation was carried out. The mean age was 7.4 years (range: 1 to 18). There were 8 congenital and 13 acquired amputations (7 trauma, 4 infection, 1 tumor, 1 vascular). Sequential radiographs were evaluated for frontal and sagittal plane alignment. Deformity was defined as an angular deviation greater than 5 degrees.
RESULTS : Angular deformity was identified in 8 (38%) patients. Two patients had valgus deformity, 2 had varus deformity, and 1 had isolated recurvatum deformity. One patient had valgus procurvatum and 1 patient had varus recurvatum deformity. There was a mean stump revision rate of 1.38 in the congenital group and 0.85 in the acquired group. Three patients underwent deformity correction using an external fixator owing to difficulty with prosthetic fitting. All patients experienced improved fitting of their prosthesis after surgery.
CONCLUSIONS : Angular deformity can arise in children with transtibial amputations and may influence prosthesis fit and gait. Clinical and radiographic surveillance is important, and surgical correction may be of benefit. Surprisingly, stump revision rate was similar in both groups.
PMID: 20104153
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