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Osteocartilaginous capping effective treatment for recurrent overgrowth after amputation in children
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Autologous osteocartilaginous capping with the proximal portion of the fibula is an effective treatment after congenital or acquired amputations in children, where 90% of limbs showed no recurrent overgrowth, according to study results.
The researchers reviewed the records of 47 patients (50 tibiae, mean age at surgery: 7.6 years) who underwent amputations with an autologous osteocartilaginous cap for treatment of osseous overgrowth of the tibia between 1990 and 2011. Additionally, the 31 tibiae-acquired amputations were compared with the 19 tibiae congenital amputations.
Utilizing logistic regression analysis, the researchers analyzed the correlation between amputation type, complication development and influence control over other factors.
Results showed, after the initial capping surgery, four patients required revision surgery for recurrent overgrowth at a mean of 5.4 years.
There were 10 patients with a total of 16 complications that required 25 additional surgeries. Two of the patients required no further surgery, according to the researchers.
Research findings indicated, besides recurrent overgrowth, the most common complications were late inadequate soft-tissue coverage and skin breakdown, which required additional surgical procedures. Additionally, two patients developed infections.
According to the researchers, the acquired amputations, compared with the congenital amputations, were not significantly different with regard to age, sex, duration of follow-up, age at follow-up, revision time, complications and additional surgery. The type of amputation was not a predictor for the number of complications observed in patients. ‒ by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.
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