Osseous overgrowth after amputation in adolescents and children.
We retrospectively studied the incidence of primary surgical revision for stump overgrowth in a population of childhood and adolescent amputees. The anatomic location and the etiology of amputation are critical to the occurrence of overgrowth needing revision. Metaphyseal-level amputations are the most likely to develop overgrowth requiring revision (50%), whereas diaphyseal amputations are slightly less likely (45%). Joint disarticulations never develop overgrowth. Traumatic amputations are the most frequent mode of injury requiring revision of overgrowth (43%), followed by congenital or intrauterine amputations (30%) and elective amputations (20%). Radiographic classification of the osseous overgrowth helps define its severity and degree of ossific progression. Surgical revisions are usually performed when overgrowth reaches a grade 3 classification. The majority of skeletally immature diaphyseal- or metaphyseal-level amputees, including those with certain preexisting orthopaedic conditions, retain the ability to develop osseous overgrowth at the apex of the stump skeleton.
O'Neal
M L
ML
Shriners Hospital for Crippled Children, Tampa Unit, Florida, USA.
Bahner
R
R
Ganey
T M
TM
Ogden
J A
JA
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects*; D000672:Amputation Stumps / Q000000981:diagnostic imaging / Q000601:surgery; D000673:Amputation, Traumatic / Q000150:complications* / Q000000981:diagnostic imaging; D001134:Arm Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018483:Diaphyses / Q000293:injuries / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007869:Leg Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies