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Birch JG, Paley D, Herzenberg JE, et al. Amputation Versus Staged Reconstruction for Severe Fibular Hemimelia: Assessment of Psychosocial and Quality-of-Life Status and Physical Functioning in Childhood. JB JS Open Access. 2019;4(2):e0053doi: 10.2106/JBJS.OA.18.00053.
Birch, J. G., Paley, D., Herzenberg, J. E., Morton, A., Ward, S., Riddle, R., Specht, S., Cummings, D., & Tulchin-Francis, K. (2019). Amputation Versus Staged Reconstruction for Severe Fibular Hemimelia: Assessment of Psychosocial and Quality-of-Life Status and Physical Functioning in Childhood. JB & JS open access, 4(2), e0053. https://doi.org/10.2106/JBJS.OA.18.00053
Birch, John G, et al. "Amputation Versus Staged Reconstruction for Severe Fibular Hemimelia: Assessment of Psychosocial and Quality-of-Life Status and Physical Functioning in Childhood." JB & JS open access vol. 4,2 (2019): e0053. doi: https://doi.org/10.2106/JBJS.OA.18.00053
Birch JG, Paley D, Herzenberg JE, Morton A, Ward S, Riddle R, Specht S, Cummings D, Tulchin-Francis K. Amputation Versus Staged Reconstruction for Severe Fibular Hemimelia: Assessment of Psychosocial and Quality-of-Life Status and Physical Functioning in Childhood. JB JS Open Access. 2019 Apr 05;4(2):e0053. doi: 10.2106/JBJS.OA.18.00053. eCollection 2019. PMID: 31334463; PMCID: PMC6613853.
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JB JS Open Access. 2019 Apr 05;4(2):e0053. doi: 10.2106/JBJS.OA.18.00053. eCollection 2019.

Amputation Versus Staged Reconstruction for Severe Fibular Hemimelia: Assessment of Psychosocial and Quality-of-Life Status and Physical Functioning in Childhood.

JB & JS open access

John G Birch, Dror Paley, John E Herzenberg, Anne Morton, Shana Ward, Russ Riddle, Stacy Specht, Don Cummings, Kirsten Tulchin-Francis

Affiliations

  1. Texas Scottish Rite Hospital for Children, Dallas, Texas.
  2. Paley Orthopedic and Spine Institute, West Palm Beach, Florida.
  3. The International Center for Limb Lengthening, Sinai Hospital of Baltimore, Baltimore, Maryland.

PMID: 31334463 PMCID: PMC6613853 DOI: 10.2106/JBJS.OA.18.00053

Abstract

BACKGROUND: Fibular hemimelia, a congenital disorder characterized by the partial or complete absence of the fibula, tibial growth inhibition, and foot and ankle deformity and deficiency, is the most common deficiency of long bones. The purpose of the present study of children with congenital fibular hemimelia was to examine the functional and psychosocial outcomes at a minimum of 2 years after treatment either with amputation and a prosthesis or with reconstruction and lengthening.

METHODS: Twenty children who were managed with primary amputation were compared with 22 children who were managed with staged limb reconstruction. The average age of the patients at the time of evaluation was 9 years (range, 5 to 15 years). Patients and parents completed psychosocial, quality-of-life, and satisfaction surveys. Patients underwent instrumented gait analysis and a timed 25 or 50-yard dash. The number and nature of surgical procedures were recorded from a retrospective chart review.

RESULTS: Families of children managed with amputation had lower economic and educational levels and were more ethnically diverse compared with the families of children managed with limb reconstruction. Scores on psychosocial and quality-of-life surveys were comparable with those from healthy patient populations. Parents of males treated with amputation perceived a lower school-related quality of life for their child; socioeconomic and ethnic differences between groups might account for this finding. Statistically but not clinically significant differences were measured during instrumented gait analysis at a self-selected walking speed and during a timed 25 or 50-yard dash. The majority of patients and parents reported satisfaction with the treatment method selected and would select the same treatment method again.

CONCLUSIONS: At this interim stage of growth, there were no significant functional or psychological differences between groups. Both groups were satisfied with the outcome in mid-childhood, irrespective of the selection of amputation or limb reconstruction.

LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

References

  1. Arch Phys Med Rehabil. 1997 Jul;78(7):750-4 - PubMed
  2. J Bone Joint Surg Am. 1976 Dec;58(8):1138-41 - PubMed
  3. J Bone Joint Surg Am. 2000 Dec;82(12):1732-5 - PubMed
  4. J Bone Joint Surg Am. 2009 Apr;91(4):797-804 - PubMed
  5. J Bone Joint Surg Am. 1990 Oct;72(9):1391-9 - PubMed
  6. J Orthop. 2014 Jul 18;11(4):183-7 - PubMed
  7. Clin Orthop Relat Res. 2014 Dec;472(12):3860-8 - PubMed
  8. Health Qual Life Outcomes. 2004 Sep 27;2:55 - PubMed
  9. J Bone Joint Surg Am. 1989 Feb;71(2):273-7 - PubMed
  10. J Bone Joint Surg Am. 2002 Feb;84(2):317-9 - PubMed
  11. Med Care. 2001 Aug;39(8):800-12 - PubMed
  12. J Bone Joint Surg Br. 1997 Jan;79(1):58-65 - PubMed
  13. Pain. 1987 Jan;28(1):27-38 - PubMed
  14. J Bone Joint Surg Am. 1999 Nov;81(11):1511-8 - PubMed
  15. J Pediatr Orthop B. 2010 Jan;19(1):55-60 - PubMed
  16. J Bone Joint Surg Br. 1998 Sep;80(5):772-6 - PubMed
  17. J Child Orthop. 2010 Dec;4(6):519-24 - PubMed
  18. Acta Orthop Scand. 2000 Feb;71(1):55-9 - PubMed
  19. J Pediatr Orthop. 1990 May-Jun;10(3):373-7 - PubMed
  20. J Child Orthop. 2016 Dec;10(6):557-583 - PubMed
  21. Disabil Rehabil. 2004 Jul 22-Aug 5;26(14-15):837-50 - PubMed
  22. J Bone Joint Surg Am. 1976 Jun;58(4):492-6 - PubMed
  23. J Pediatr Orthop. 2019 Oct;39(9):e708-e717 - PubMed
  24. J Bone Joint Surg Am. 1961 Jul;43-A:625-42 - PubMed
  25. J Bone Joint Surg Am. 1996 Oct;78(10):1480-5 - PubMed
  26. J Bone Joint Surg Br. 1979 May;61-B(2):133-7 - PubMed
  27. J Bone Joint Surg Am. 1975 Oct;57(7):905-9 - PubMed
  28. J Bone Joint Surg Am. 1986 Apr;68(4):573-8 - PubMed
  29. Clin Orthop Relat Res. 2011 Apr;469(4):1175-80 - PubMed
  30. J Pediatr Orthop B. 2013 Sep;22(5):450-6 - PubMed

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