Congenital orthopedic anomalies and their impact on the family.

A baby born with a congenital limb deficiency presents a challenge to parents and health care professionals. Lack of information about treatment options can exacerbate the crisis for the family. The treatment modalities available to the family generally depend on the child's specific limb deficiency or deficiencies. Surgery to reconstruct the deficiency is not a workable option for many patients because of abnormal joints and soft tissues. Amputation may be recommended for patients whose deficiency is difficult or impossible to manage prosthetically. Limb lengthening is an option only for patients whose bones are smaller than normal. Prosthetics are the most widely used treatment modality because they immediately equalize limb lengths and improve function. When a baby is born with a congenital limb deficiency, the initial response of the parents is shock and denial. In adjusting to their newborn, they must first mourn the loss of the baby they expected. Once the adjustment process begins, specific information about the limb deficiency and the treatment options should be available. Family adjustment to the child is a continual process. As the child grows, management strategies need to change to adjust to the child's changing needs. With appropriate and timely health care and family intervention, a child with a congenital limb deficiency can be a happy, successful person.