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:: Volume 5, Issue 1 (1-2016) ::
wjps 2016, 5(1): 7-14 Back to browse issues page
Pediatric Traumatic Limb Amputation: The Principles of Management and Optimal Residual Limb Lengths
Muhammad Adil Abbas Khan Dr., Ammar Asrar Javed Dr. , Dominic Jordan Rao Dr., J Antony Corner Dr., Peter Rosenfield Dr.
St. Mary's Hospital, London, UK , Johns Hopkins Hospital
Abstract:   (3671 Views)

Pediatric traumatic limb amputations are rare and their acute and long term management can be challenging in this subgroup of patients. The lengthy and costly hospital stays, and resulting physical and psychological implications leads to significant morbidity. We present a summary of treatment principles and the evidence base supporting the management options for this entity. The initial management focuses on resuscitating and stabilization of the patients, administration of appropriate and adequate analgesics, and broad spectrum antibiotics. The patient should ideally be managed by an orthopedic or a plastic surgeon and when an amputation is warranted, the surgical team should aim to conserve as much of the viable physis as possible aimed at allowing bone development in a growing child. A subsequent wound inspection should be performed to assess for signs of ischemia or non-viability of tissue. Depending on the child’s age, approximations of the ideal residual limb length can be calculated using our guidelines, allowing an ideal stump length at skeletal maturity for a well-fitting and appropriate prosthesis. Myodesis and myoplasties can be performed according to the nature of the amputation. Removable rigid dressings are safe and cost effective offering better protection of the stump. Complications such as necrosis and exostosis, on subsequent examination, warrant further revisions. Other complications such as neuromas can be prevented by proximal division of the nerves. Successful rehabilitation can be accomplished with a multidisciplinary approach, involving physiotherapist, play therapist and a child psychiatrist, in addition to the surgeon and primary care providers.

Keywords: Pediatric, Trauma, Amputation, Residual limb length
Full-Text [PDF 293 kb]   (2260 Downloads)    
Type of Study: Review Article | Subject: Special
Received: 2015/03/10 | Accepted: 2015/08/23 | Published: 2015/08/23
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Khan M A A, Javed A A, Rao D J, Corner J A, Rosenfield P. Pediatric Traumatic Limb Amputation: The Principles of Management and Optimal Residual Limb Lengths. wjps. 2016; 5 (1) :7-14
URL: http://wjps.ir/article-1-149-en.html

Volume 5, Issue 1 (1-2016) Back to browse issues page
مجله جهانی جراحی پلاستیک World Journal of Plastic Surgery
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