Pediatric Limb Deficiency (guest Lecture) Flashcards
What 2 congenital things can happen pertaining to limb deficiency
- transverse deficiency
- longitudinal deficiency
What acquired things can happen after birth leading to limb deficiency
- trauma
- infection
- tumors
- vascular malformation
Is congenital or acquired limb deficiency more common
60% congenital
What are the most common traumatic etiology for ages 1-4 and older children from limb deficiency
◦ Age 1-4: lawnmower, power tools
◦ Older child: MVA, machinery, GSW
When do limb buds appear and when are they completely developed
4th week fo embryonic development and completed by week 7
What factor during the limb bud development may be the cause for limb deficiencies
Teratogenic factor or disruption of blood supply
What are the 2 philophies for UE deficiencies
- sit to fit
- task specific
When should a baby be in a prosthetics ?
When they are able to sit up
What is crucial for sensory input for UE deficiencies
Nubbins
Adults with acquired amputations often associated with what other syndrome
VACTERL and TAR
What psychological development in adults is associated amputation and limb salvage
• amputation ->lower self-esteem
• limb salvage -> more physical complaints
What is proximal femoral focal deficiency (PFFD)
Hypoplasia of the femur
What is the Aiken classification of Proximal Femoral Focal Deficiency
A
B
C
D
- A: acetabulum present, femoral head present, shortened femoral segment
- B: well defined acetabulum, unossified femoral head at birth
- C: no femoral head and poorly defined acetabulum
- D: Extremely short or absent femur
What are sx options for Proximal Femoral Focal Deficiency
- Lengthening of the femur if hip and knee joint are stable
- amputation
- Van nes rotation oestotomy
- knee fusion
What are the clinical findings for Proximal Femoral Focal Deficiency (6)
- Hip instability
◦ Malrotation
◦ Insufficient proximal musculature
◦ Shortleverarm
◦ Limb length discrepancy
◦ Limb usually positioned in flexion, abduction and external rotation
70-80% of people with PFFD have a deficiency of what
The fibula
What are most common gait deviations with PFFD
- posterior and lateral trunk lean during stance phase due to poor strength of abductors and extensors
Why do people with PFFD have posterior and lateral trunk lean during stance phase
Bc of poor strength of abductors and extensors
What are the clinical findings of tibia limb deficiencies
- abnormal articulation of knee and ankle;e joint
- often have equinovarus foot deformity (clubfoot)
- leg length discrepancy
What is equinovarus foot deformity
Inversion of the foot
What is type 1 of tibia limb deficiencies
Complete absence of tibia ; extensor mechanism
What is type 2 of tibia limb deficiencies
Proximal tibia well formed , have quads
What is type 3 of tibia limb deficiencies
Presence of distal tibia only
If the tibia is absent for tibia hemimelia what kind of knee problem is there
Disarticualtion
