ACPOC - The Association of Children's Prosthetic-Orthotic Clinics Founded in 1978

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Epidemiological Survey of Triple and Quadruple Amputees

The charts of all triple and quadruple limb deficient children (including both longitudinal and transverse deficiencies) treated at the Amputee Clinic of the Hugh MacMillan Rehabilitation Center in Toronto between 1962 and 1989 were reviewed in order to evaluate the incidence, sex distribution, anatomical site, severity and possible factors responsible for these limb deficiencies.

There were 58 patients: 49 were congenital, 8 secondary to meningococcemia and one post-electrical burns.

We noticed a sharp increase in the incidence of both congenital and acquired multiple amputations over the last few years. In the period 1962 to 1969, 16 patients were treated at our clinic-including one post meningococcemia and 5 due to thalidomide. In the period 1970 to 1979 there were 12 new patients treated at our Center, all congenital, while in the period 1980 to 1989 there were 30 new patients: 23 congenital and 7 post-meningococcemia.

Drug intake during pregnancy was documented in 16 cases. These included 3 diabetic mothers. Of the 49 patients with congenital deficiencies, 37 (76%) were males. There were 31 quadruple and 27 triple amputees.

All 58 patients were anatomically classified and evaluated according to the severity of the deficiencies, ranging from complete absence of the whole limb to partial amputation of hands and feet.

Hospital for Sick Children, 77 Elm Street, #104, Toronto, Ontario, Canada M5G 1114