Surgical principles related to paediatric congenital and acquired upper and lower limb amputations

Abstract

Surgical treatment of transverse congenital deficiencies is rarely needed. Rudimentary digital nubbins are rarely removed. Separation of the radius and ulna the Krukenberg procedure to enable children with transverse deficiencies of the distal forearm or wrist to gain a chopstick-like grip, is of historical interest. Bone overgrowth, producing a spike, occurs infrequently in children with transverse deficiencies due to failure of normal limb formation. It is more frequent when the amputation results from amniotic bands. Trimming the overgrown stump and capping it with a piece of iliac crest cartilage the Marquardt procedure or trimming of the stump alone is indicated if the spike is painful.