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Surgical Technique for Varus Deformity Correction of Below-Knee Stump in a Paediatric Patient
Paediatric amputation is one of the treatment options for various indications, namely, trauma, infection, tumour and congenital problems, and some may be born with congenital problems. It differs from adult amputation as they have higher physical demands, and special complications may arise. Stump o...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544382/ https://www.ncbi.nlm.nih.gov/pubmed/37791173 http://dx.doi.org/10.7759/cureus.44477 |
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author | Nik Abdul Adel, Nik Alyani Abdul Razak, Ardilla Hanim Sri Ramulu, S Suresh Awang, Mohd Shukrimi |
author_facet | Nik Abdul Adel, Nik Alyani Abdul Razak, Ardilla Hanim Sri Ramulu, S Suresh Awang, Mohd Shukrimi |
author_sort | Nik Abdul Adel, Nik Alyani |
collection | PubMed |
description | Paediatric amputation is one of the treatment options for various indications, namely, trauma, infection, tumour and congenital problems, and some may be born with congenital problems. It differs from adult amputation as they have higher physical demands, and special complications may arise. Stump overgrowth by far is the commonest complication in paediatric transosseous amputation, while varus deformity of the tibia stump was reported sparsely in the literature. The growth discrepancy of the proximal tibia and fibula physis coupled with distal tibiofibular synostosis may have resulted in proximal migration of the fibula, which later resulted in varus deformity of the stump. This will cause difficulty in prosthesis fitting and lead to painful stumps due to the pressure at the abnormal bony prominence. We report a case of congenital limb deficiencies in a 12-year-old male who was treated with below-knee amputation (BKA) and experienced progressive varus deformity of the stump that caused pain during prosthetic wear, which interfered with his gait. He had a varus deformity of 15 degrees of the stump, distal tibiofibular synostosis and proximal migration of the fibula head. As the conservative management by modification of the prosthesis had failed, he underwent open wedge proximal tibia corrective osteotomy, division of the synostosis and reduction of the fibula head. The surgical intervention was successful in alleviating his problem. All efforts must be made to ensure optimum prosthetic fitting in paediatric amputation patients to maintain the patient’s daily lifestyle and activities. |
format | Online Article Text |
id | pubmed-10544382 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-105443822023-10-03 Surgical Technique for Varus Deformity Correction of Below-Knee Stump in a Paediatric Patient Nik Abdul Adel, Nik Alyani Abdul Razak, Ardilla Hanim Sri Ramulu, S Suresh Awang, Mohd Shukrimi Cureus Physical Medicine & Rehabilitation Paediatric amputation is one of the treatment options for various indications, namely, trauma, infection, tumour and congenital problems, and some may be born with congenital problems. It differs from adult amputation as they have higher physical demands, and special complications may arise. Stump overgrowth by far is the commonest complication in paediatric transosseous amputation, while varus deformity of the tibia stump was reported sparsely in the literature. The growth discrepancy of the proximal tibia and fibula physis coupled with distal tibiofibular synostosis may have resulted in proximal migration of the fibula, which later resulted in varus deformity of the stump. This will cause difficulty in prosthesis fitting and lead to painful stumps due to the pressure at the abnormal bony prominence. We report a case of congenital limb deficiencies in a 12-year-old male who was treated with below-knee amputation (BKA) and experienced progressive varus deformity of the stump that caused pain during prosthetic wear, which interfered with his gait. He had a varus deformity of 15 degrees of the stump, distal tibiofibular synostosis and proximal migration of the fibula head. As the conservative management by modification of the prosthesis had failed, he underwent open wedge proximal tibia corrective osteotomy, division of the synostosis and reduction of the fibula head. The surgical intervention was successful in alleviating his problem. All efforts must be made to ensure optimum prosthetic fitting in paediatric amputation patients to maintain the patient’s daily lifestyle and activities. Cureus 2023-08-31 /pmc/articles/PMC10544382/ /pubmed/37791173 http://dx.doi.org/10.7759/cureus.44477 Text en Copyright © 2023, Nik Abdul Adel et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Physical Medicine & Rehabilitation Nik Abdul Adel, Nik Alyani Abdul Razak, Ardilla Hanim Sri Ramulu, S Suresh Awang, Mohd Shukrimi Surgical Technique for Varus Deformity Correction of Below-Knee Stump in a Paediatric Patient |
title | Surgical Technique for Varus Deformity Correction of Below-Knee Stump in a Paediatric Patient |
title_full | Surgical Technique for Varus Deformity Correction of Below-Knee Stump in a Paediatric Patient |
title_fullStr | Surgical Technique for Varus Deformity Correction of Below-Knee Stump in a Paediatric Patient |
title_full_unstemmed | Surgical Technique for Varus Deformity Correction of Below-Knee Stump in a Paediatric Patient |
title_short | Surgical Technique for Varus Deformity Correction of Below-Knee Stump in a Paediatric Patient |
title_sort | surgical technique for varus deformity correction of below-knee stump in a paediatric patient |
topic | Physical Medicine & Rehabilitation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544382/ https://www.ncbi.nlm.nih.gov/pubmed/37791173 http://dx.doi.org/10.7759/cureus.44477 |
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