Limb Deficiencies And Amp Flashcards
When do limb buds first appear?
End of 4th week of embryonic development
When is there a recognizable skeleton?
End of the 7th week
Causative factors for improper limb development
Must be present at some time between 3rd and 7th week of development
Thalidomide
Contraceptives
Irradiation
Limb deficiency classification
Failure of formation of parts (arrested development)
Failure of differentiation (separation of the parts)
Duplication
Overgrowth
Undergrowth
Congenital constriction band syndrome
Generalized skeletal deformities
Transverse limb development
Normally until a certain level beyond which no skeletal elements exist
Most are unilateral
Most common transverse UE deficiency below elbow
Longitudinal limb growth
Reduction or absence of a limb element w/in long axis of lumb
Most common LE deficiency
Abscence or hypoplasia of proximal femur with varying degrees of involvement of the acetabulum, femoral, head, patella, tibia fibula
May be unilateral or bilateral
Clinical pattern of short leg held in flexion, abduction and ER
70-80% have total longitudinal deficiency of the fibula
Acquired amputations 70-80% attributed to
Trauma
Leading causes of acquired amputations
Machinery Household power tools MVA GSW Railroad accidents
Rest due to disease: tumor, infection, vascular abnormalities
Disease related amputations
Primary bone tumors rare in children
Osteosarcoma: primary malignant tumor of bone
Cause unknown but can be linked to ionsizing radiation
Peak incidence is w/ pubertal growth spurt
Common site for osteosarcoma
Distal femur
Proximal tibia
Humerus
Ewing’s sarcoma
Malignant primary tumor
Involve both the bone and soft tissue at time of dx
Pelvis, femur, tibia, ribs, humerus
Amputation: preserve
Physes if possible to allow for growth
60% of predicated femoral length needed for
Lengthening procedure to be viable
Sx option for PFFD if lengthening not an option
Knee arthodesis and foot amputation
