Characteristics of the child amputee population.

The characteristics and number of children with limb amputations in North America are not known. In an effort to secure information concerning the nature of the child amputee population (to 21 years of age) in the United States and Canada, a census of patients treated at member clinics of the Association of Children's Prosthetic-Orthotic Clinics (ACPOC) was conducted. It was designed to obtain a rational basis for children's prosthetic design, development, research, and educational activities. Of the 74 ACPOC prosthetic clinics to which the questionnaire was sent, 45 replies were analyzed, representing a total of 4,105 children under treatment at the reporting clinics during 1980, of which 679 cases (17%) were seen for the first time in that year. The results are consistent with prior unpublished censuses. Overall, congenital limb deficiencies outnumbered acquired losses by a ratio of 2:1, but among unilateral cases, more lower-limb amputations were acquired postpartum than congenitally. Eighty percent of all child amputees had had only one limb involved, and 54% of these unilateral cases were left amputees. Males outnumbered females 3:2, and over half of the children currently under treatment at the reporting clinics had been under 6 years of age at the time of first admission.