pediatrics
Congenital Limb Abnormalities
Treatment of Congenital Limb Abnormalities
Surgical procedures Prosthetic devices Treatment consists of surgical procedures for polydactyly and syndactyly. Treatment for missing or hypoplastic limbs is mainly through the use of prosthetic devices, which are most useful for lower-limb deficiencies and for completely or almost completely absent upper limbs. If any activity in an arm or hand exists, no matter how great the malformation, functioning capacity must be thoroughly assessed before a prosthesis or surgical procedure is recommended. Therapeutic amputation of any limb or portion of a limb should be considered only after evaluating the functional and psychologic implications of the loss and when amputation is essential for fitting a prosthesis. An upper-limb prosthesis should be designed to serve as many needs as possible so that the number of devices is kept to a minimum. Children use a prosthesis most successfully when it is fitted early and becomes an integral part of their body and body image during the developmental years. Devices used during infancy should be as simple and durable as possible (eg, a hook rather than a bioelectric arm). With effective orthopedic and ancillary support, most children with congenital amputations lead normal lives. 