Amputations during childhood and juvenile age differ from those in adults: Osseous over-growth can be expected especially in trans-humeral and trans-tibial stumps,--to be prevented by stump-capping. After loss of a growth-plate transosseous stumps will reduce growth; therefore it is crucial to preserve the distal femoral growth-plate and a weight-bearing knee-disarticulation stump with respect to future prosthetic function and appearance. Besides predominantly traumatic origin of acquired amputations in the growth-period longitudinal deficiencies present at birth have to attract utmost attention when decision-making for surgical conversion--e.g. of a missing tibia to a knee-disarticulation stump or severe fibular deficiency to a weightbearing Symeor modified Pirogoff-/Boyd-stump. The multiple limb-deficient child and adolescent depends on a holistic approach towards therapy provided by specialised centers.

Adolescent↗

PubMedDate not supplied

[Hindfoot stump formation in peripheral vascular disorders].

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Aged↗

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Knee-disarticulation.

The disarticulation of the knee joint is--in contrary to the above-knee level--a fast and tender method for amputation, resulting in a vigorous, complete weightbearing stump. Without problems the bulky stump is fitted in an exactly moulded plastic or resin socket--eventually combined with a soft socket--, which can be easily put on and off also by older patients suffering from general dysvascular disorders. Nowadays special joints are used for functionally as well as cosmetically satisfying knee-disarticulation-prostheses. The surgical technique with alternative incisions, the peculiarities in dysvascular patients, the postoperative care including immediate or early fitting, the management after wound-healing with a temporary exercise-prosthesis and finally the various possibilities of the definitive prosthetic fitting are stressed in detail.

Artificial Limbs↗