Osseous Overgrowth in Congenital Limb-Deficient Children

RAYMOND J. LOVETT, MD*


The most common surgical complication in the traumatic juvenile amputee is osseous overgrowth. It is relatively rare in the congenital limb-deficient child, and is reported to occur only in children with amniotic band syndrome. The purpose of this study is to investigate the occurrence of overgrowth in the congenitally limb-deficient child, to determine if there was a unique sub-group of children that were affected by this complication. Two groups were analyzed: 1) all children with congenital amputations necessitating surgical revisions for osseous overgrowth since 1950 (total 20); and 2) all children with congenital below-knee amputations (total 30). Retrospective chart analysis and review of X-rays were performed.

Of those with surgical revisions, fourteen were identified as having amniotic band syndrome. Of the remaining six, all had revisions for humeral overgrowth, and failure of formation was found in other limbs. Among below-knee amputees, eighteen had amniotic constriction band, of which ten had had revisions-and the remaining eight were radiographically identified as having bursae or non-clinical symptoms of osseous overgrowth. More accurate clinical diagnosis of amniotic band syndrome is needed so that treatment can be better directed, and appropriate guidance be given to parents.

*Area Child Amputee Center; 235 Wealthy SE, Grand Rapids, MI 49503