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

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Marquardt Stump Capping for Overgrowth

Since Marquardt described his procedure of using an epiphysis (usually the proximal fibula) as a cap to prevent overgrowth of a distal tibial amputation stump no series has been published. We present thirteen stump capping procedures done on ten patients between July 1989 and Jan. 1992.

Patients range in age from 4 to 15 yrs at operation and have been followed from 4 to 35 months with a mean of 14 mo. The proximal fibula was used as the donor in ten limbs and each end of the 1st metatarsal head (at conversion ampuation of a lower limb) in two and the iliac crest in one patient. The recipient sites were humerus in four, and tibia in nine.

Recurrent overgrowth requiring reoperation has not occurred in any limbs. One patient (who lost his tibia due to Purpura Fulminans) developed a post operative wound slough at the site of old split thickness skin coverage and subsequently desquemated the cap.

These data are preliminary since follow-up time is short. However, it appears at this time that the procedure is worthy of consideration.

Shriners Hospital L.A., 3160 Geneva Street, Los Angeles, CA 90020