Orthopedic and Prosthetic Treatment of Separated Siamese Twins
J. I. KRAJBICH, MD, FRCS(C),BRIAN GIAVEDONI, BSc, CP(C) ANDSHEILA HUBBARD, DIP. P and OT, BSc*
The unique orthopedic, prosthetic, and physiotherapy management of Siamese twins following a complex 17-hour surgical separation is presented by a multi-disciplinary clinic team. The 2-'/z year old twins from Burma were conjoined from chest to pelvis. Each had one lower limb and shared a third useless limb as well as pelvis, liver, intestines, urinary tract, and male genitals. The postsurgical problems of developmental delay, spinal deformity, hemipelvectomy deficiency, and abnormal remaining lower limb are discussed as they applied individually to the twins. The management approach varied for each one and, in the case of the more severely involved child, required the fabrication of an innovative prosthetic-orthotic device. Satisfactory correction of most of the existing deformities and functional prosthetic fittings were eventually achieved for the twins prior to their return to Burma.
*The Hugh MacMillan Medical Centre, 350 Rumsey Road, Toronto, Ontario M4G 1R8