Neff G
Abteilung für Technische Orthopädie, Dysmelie und Rehabilitation, Orthopädische Klinik der FU Berlin, Oskar-Helene-Heim.
Z Orthop Ihre Grenzgeb. 1994 May-Jun;132(3):227-34. doi: 10.1055/s-2008-1039967.
Amputations during childhood and juvenile age differ from those in adults: Osseous over-growth can be expected especially in trans-humeral and trans-tibial stumps,--to be prevented by stump-capping. After loss of a growth-plate transosseous stumps will reduce growth; therefore it is crucial to preserve the distal femoral growth-plate and a weight-bearing knee-disarticulation stump with respect to future prosthetic function and appearance. Besides predominantly traumatic origin of acquired amputations in the growth-period longitudinal deficiencies present at birth have to attract utmost attention when decision-making for surgical conversion--e.g. of a missing tibia to a knee-disarticulation stump or severe fibular deficiency to a weightbearing Symeor modified Pirogoff-/Boyd-stump. The multiple limb-deficient child and adolescent depends on a holistic approach towards therapy provided by specialised centers.
尤其是在经肱骨和经胫骨残肢,预计会出现骨质过度生长,可通过残端覆盖来预防。生长板缺失后,经骨残肢会减缓生长;因此,为了未来的假肢功能和外观,保留股骨远端生长板和负重膝关节离断残肢至关重要。除了生长期后天截肢主要由创伤引起外,出生时存在的纵向缺陷在决定手术转换时(例如将缺失的胫骨转换为膝关节离断残肢,或将严重的腓骨缺陷转换为负重的Syme或改良Pirogoff-/Boyd残肢)必须引起最大关注。多肢体缺陷的儿童和青少年依赖于专业中心提供的整体治疗方法。