Department of Rehabilitation Medicine, University of Washington & VA Puget Sound Health Care System (VAPSHCS), Seattle, WA 98108, USA.
Department of Physical Medicine and Rehabilitation, University of Michigan, 325 East Eisenhower Parkway, Suite 200, Ann Arbor, MI 48108, USA.
Phys Med Rehabil Clin N Am. 2024 Nov;35(4):707-724. doi: 10.1016/j.pmr.2024.05.005. Epub 2024 Jul 9.
Pediatric limb loss or limb deficiency is uncommon in the United Sates occurring 1 per 1943 live births per year, with a ratio of 2:1 upper to lower extremity. Causes include congenital limb deficiency, and less frequently, limb loss secondary to trauma, cancer, or other illnesses. Vascular disruption, particularly as seen in amniotic band syndrome, stands as the leading suspect in the multifaceted and intricate causes of congenital limb loss. Children with limb difference and deficiency present unique medical and rehabilitation challenges. Physical Medicine and Rehabilitation (PM&R) physicians are uniquely equipped to navigate these complexities. Prosthetic prescription and fabrication for children require balancing scientific principles with individual needs. A "one-size-fits-all" approach is ineffective. Many diverse factors impact prosthetic prescription and fabrication, including amputation level, residual limb characteristics, cognitive/developmental age, family goals, financial resources, and medical literacy.
小儿肢体缺失在美国并不常见,每年每 1943 例活产中出现 1 例,上肢与下肢的比例为 2:1。其病因包括先天性肢体缺失,以及较少见的因创伤、癌症或其他疾病导致的肢体缺失。血管中断,尤其是在羊膜带综合征中可见,是导致先天性肢体缺失的多因素、复杂病因的主要原因。肢体差异和缺失的儿童存在独特的医疗和康复挑战。物理医学与康复(PM&R)医生具备解决这些复杂性问题的独特能力。儿童假肢的处方和制作需要在科学原理和个体需求之间取得平衡。“一刀切”的方法是无效的。许多不同的因素会影响假肢的处方和制作,包括截肢部位、残肢特征、认知/发育年龄、家庭目标、经济资源和医学素养。