Sự khác biệt quan trọng tồn tại trong việc quản lý những người tàn tật trẻ em và người lớn. Nhiều yếu tố, bao gồm cả nguyên nhân của thiếu hụt chi thời thơ ấu, dự kiến tăng trưởng xương, chức năng nhu cầu về hệ thống vận động và chân tay giả, gốc xương appositional phát triển quá mức, | Lower-Limb Deficiencies and Amputations in Children J. Ivan Krajbich MD Abstract Important differences exist in the management of child and adult amputees. Many factors including the etiology of childhood limb deficiencies expected skeletal growth functional demand on the locomotor system and prosthesis appositional bone stump overgrowth and psychological challenges make caring for these young patients particularly challenging. Adherence to the general principles of childhood amputation surgery will typically guide one to the optimal functional result. These principles can be summarized as follows 1 Preserve length. 2 Preserve important growth plates. 3 Perform disarticulation rather than transosseous amputation whenever possible. 4 Preserve the knee joint whenever possible. 5 Stabilize and normalize the proximal portion of the limb. 6 Be prepared to deal with issues in addition to limb deficiency in children with other clinically important conditions. A large proportion of young amputees undergo a Syme disarticulation modified Boyd amputation or knee disarticulation. A modified Van Nes rotationplasty procedure is also useful in this age group. All these provide the child with a weight-bearing stump with good growth potential and no complications due to bone overgrowth. Appropriate timing of amputation procedures and prosthetic fittings is essential to maximize functional benefit to the patient. J Am Acad Orthop Surg 1998 6 358-367 Many medical articles dealing with children begin with the statement that children are not small adults. This is also very much the case in the realm of pediatric amputations and limb deficiencies. This fact has been well recognized among pediatric orthopaedic surgeons prosthetists and therapists with a large pediatric practice. In recognition of the unique features of this group of patients the Association of Children s Prosthetic-Orthotic Clinics was founded in 1948 with the goal of advancing knowledge about the treatment of children .
