Failure of Formation of Parts: Transverse Arrest (Continued)
If a prosthesis is used, the length of the stump and the patient’s age determine the type of prosthesis. The infant with a very short below-elbow stump is fitted with…
Foot Prehensility in Amelia
I. Failure of Formation of Parts (Transverse and Longitudinal Arrest) II. Failure of Differentiation of Parts III. Duplication IV. Overgrowth V. Undergrowth VI. Congenital Constriction Band Syndrome VII. Generalized Skeletal…
Failure of Formation of Parts: Transverse Arrest
Wrist Disarticulation Type. This apparently autosomal recessive trait is more common in females and is seldom bilateral. Typically, the stump is long, and skin nubbins represent failure of digit development….
Growth Factors
The growth and development of the limbs are controlled by specific genes. At the tip of each limb bud is a collection of ectodermal cells called the apical ectodermal ridge…
Ilizarov and De Bastiani Techniques for Limb Lengthening
Chondrodiastasis, or symmetric distraction of the growth plate, can be considered when the leg-length discrepancy is small. The procedure stimulates closure of the growth plate; however, its use is limited…
Growth Arrest
Lengthening is appropriate to consider in children 8 to 12 years of age who have a predicted leg-length discrepancy at maturity of 5 cm or more. The discrepancy in a…
Charts for Timing Growth Arrest and Determining Amount of Limb Lengthening to Achieve Limb-Length Equality at Maturity
The advent of improved clarity of intraoperative radiographic image intensification has facilitated the use of a closed technique, percutaneous epiphysiodesis. A very small incision is made over a Steinmann pin…
Evaluation of Leg-Length Discrepancy
The Green and Anderson growth-remaining chart is used to estimate the effects of an epiphyseal arrest procedure on the distal femur and proximal tibia at various skeletal ages. The arithmetic…
Clinical Manifestations
• Congenital and developmental anomalies with terminal limb deficiencies (see Plate 3-32): hemihypertrophy or hemiatrophy, Klippel-Trénaunay-Weber syndrome, Maffucci syndrome, posterior bowing of the tibia, proximal femoral focal deficiency, congenital short…
Congenital Bowing of the Tibia
Posteromedial bowing spontaneously and markedly corrects in the first 6 months of life, with essentially normal tibial angulation noted by the age of 2 years. Surgical deformity correction is rarely…
