A Long-Term Review of Children with Congenital and Acquired Upper-Limb Deficiency

T. R. SCOTLAND, MB, CHB AND H. R. GALWAY, MD*Toronto, Ontario

Wearing patterns of 131 children fitted with upper-limb prostheses at the Ontario Crippled Children's Centre between 1965 and 1975 were analyzed. One hundred sixteen children had congenital deficiencies and 15 had acquired amputations. Of 42 children who abandoned their prostheses, 37 had congenital deformities and five were acquired amputees. The most important criterion in determining whether the prosthesis would be accepted was the level of deficiency. The longer the below-elbow amputation limb, the more likely it was that the child would discard the prosthesis. Overall, half of patients fitted over the age of 2 years abandoned their prostheses compared with only 22 percent of children who had been fitted earlier than 2 years. The greatest drop-out rate occurred at the age of 13 years when adolescent amputees became more conscious of their appearance. Embarrassment because of the appearance of a hook was an important factor. Perhaps group therapy with teenagers could encourage continued wear.

*Ontario Crippled Children's Center, 350 Rumsey Road, Toronto, Ontario M4G, Canada