Amputation In Children Research Articles

Fingertip amputations in children: Atasoy flap’s indications and limitations

IntroductionThe Atasoy flap is considered simple and reliable for covering distal digital defects in adults. Various studies in children have shown more contrasting results, particularly in terms of aesthetics and function. The aim of this study is to evaluate the long-term results of this flap specifically in children, in order to determine its limitations and indications. HypothesisThe Atasoy flap is reliable and reproducible for coverage of distal digital substance loss up to zone 2 in children. Materials and methodsFifty-six children who benefited from an Atasoy flap operated on between January 2017 and January 2020 were included. Lesion area, operative technique, postoperative complications (infection, healing difficulties, necrosis), and ultimately nail appearance, cold intolerance or finger pain, finger eviction, extension defect, and final parental satisfaction were analyzed. ResultsForty-nine children were evaluated with a mean follow-up of 18 months (min = 3 months, max = 38 months, SD = 11.3 months). Eighteen children had a hook nail, resulting in 6 of them having their finger excluded. The majority of hook nails were found in zone III and in proximal zone II lesions (12 cases). Eighty-nine percent of children with distal suture fixation to the nail bed (8 children) had this complication. Cold intolerance was present in 9 children. There were no cases of extension failure or early post-operative complications. Final parent satisfaction was 9.1/10 (min = 5, max = 10, SD = 1.3). ConclusionThe Atasoy flap in children appears reliable for covering loss of distal digital substance. The main complication is the occurrence of hook nails. Compliance with its indications (transverse substance loss not exceeding the proximal third of zone II) and a precise surgical technique (distal needle fixation without suturing to the nail bed, deep flap lift, non-closure of the donor site) help limit this risk. Level of evidenceIV; retrospective study.

Case Report: Halting terminal osseous overgrowth post tibia amputation in children: a report of three cases

Terminal osseous overgrowth is a common complication after trans-diaphyseal amputation in children, leading to pain, soft tissue problems, and recurrent surgical procedures. We report three different cases with post-amputation issues of osseous overgrowth, ulceration, and deformity over the amputation site. The first case involves a 9-year-old boy with a right leg congenital amputation secondary to amniotic band syndrome. The right below-knee stump later experienced recurrent episodes of osseous overgrowth, leading to ulceration. After the prominent tibia was resected and capped with the ipsilateral proximal fibula, a positive outcome was achieved with no more recurrent overgrowth over the right leg stump. The second case involves a 9-year-old girl born with an amniotic constriction band over both legs. Her left leg remained functional after a circumferential Z-plasty, but the right leg was a congenital below-knee amputation. Multiple refashioning surgeries were performed on the right leg due to osseous overgrowth but the patient continued to experience recurrent overgrowth causing pain and difficulty fitting into a prosthesis. We performed osteocartilaginous transfer of the proximal part of the ipsilateral fibula to the right tibial end, successfully preventing the overgrowth of the tibia without any complications. The third case involves an 11-year-old boy with a history of meningococcal septicemia who underwent a right below-knee amputation and left ankle disarticulation due to complications of septic emboli. He experienced a prominent right distal tibia stump, which later developed into valgus deformity as a result of the previous insult to the proximal tibial growth plate. We performed a corrective osteotomy over the proximal right tibia and capped the entire tibia with the ipsilateral fibula as an intramedullary splint for the osteotomy site. Post-operatively, we achieved satisfactory deformity correction and successfully halted the recurrent overgrowth over the right tibia stump. The method of ipsilateral fibula capping is safe and effective in managing the osseous overgrowth complications in trans-diaphyseal amputations among children. Therefore, it is a reasonable option during primary below-knee amputations in children compared to multiple refashioning surgeries.

Fingertip traumatic amputations in children. Treatment with semiocclusive foil dressings-preliminary results

Introduction: Traumatic fingertip amputations in childhood constitute 2% of all hand injuries in individuals under the age of 14. These injuries have a significant impact on the psychological and emotional well-being of both the children and their parents. The treatment is multifactorial, dependent on the severity and location of the injury, and can involve both conservative and surgical approaches.
 Materials and Methods: The study involved 6 patients between the ages of 8 and 15 with fingertip amputations of the hand. The average duration of treatment with semi-occlusive dressings was between 3-4 weeks. The dressing was changed once a week, and after the final dressing, the border between the wound surface and healthy skin was treated with epithelializing ointments.
 Results: The average duration of treatment was 20-30 days. On average, dressings were changed 3-5 times throughout the treatment period. After the completion of treatment, the pulp had a normal shape, and the cosmetic outcome was excellent. No contractures were observed in the adjacent joints, and the two-point discrimination test had an average value of 2.5 mm.
 Discussion: Fingertip amputations present challenging injuries with multiple available treatment strategies. The presented technique is relatively simple to apply, reduces pain and discomfort, and allows direct visualization of the wound surface without the need for frequent dressing changes. Treatment with semi-occlusive dressings is a minimally invasive method, particularly suitable for the pediatric age group.
 Conclusion: Treatment of fingertip amputations with semi-occlusive foil dressings offers several advantages in childhood. Regular patient follow-up and cooperation from both the child and the parents are essential prerequisites for successful treatment.

Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review.

Introduction The aim of this study was to explore the outcomes of composite grafts in fingertip amputations in children as well as the contributing factors that may affect outcomes. Methods Literature search was conducted across six databases in March 2022 to select studies on the use of composite grafts on fingertip amputations in the pediatric population. Results Twelve articles with 735 composite grafts were identified for review. Most fingertip injuries occurred in the less than 5-year age group and were due to crush type injuries. In studies that reported "complete" graft take as a separate outcome measure, 17.3% of fingertips with this result were observed. In the studies that reported "complete" and "partial" graft take together as an outcome measure, 81.6% of fingertips achieved this outcome. A lower proportion of failed graft take was observed in more distal fingertip amputations. Infection (3.8%) and nail abnormalities (3.4%) were the most common complications following composite grafting. Conclusion Composite grafting can be considered as a useful method of treatment in this population. Clinicians should be aware of the potential complications following this method of treatment such as infection and nail abnormalities. More proximal fingertip amputations may warrant other surgical interventions (beyond Level II on the modified Ishikawa/Ishikawa classification). Significant heterogeneity was observed within the studies, mainly due to lack of standardization in assessment and reporting of outcomes.

Cancer-Specific Survival after Limb Salvage versus Amputation in Children and Adolescents with Osteosarcoma: A Population-Based Analysis with Propensity Score Matching.

The study aims to identify whether osteosarcoma patients of children and young adults will benefit from a survival profit from the choice of the operation method. The National Cancer Institute SEER database from 2000 to 2018 was selected for a retrospective analysis of 1630 children and young adults with a primary diagnosis of osteosarcoma, 1222 who underwent limb-preserving surgery, and 408 who underwent amputation. Confounders were controlled for by propensity score matching (PSM), cancer-specific survival (CSS) was analyzed using the Kaplan-Meier method, and univariate and multivariate Cox regression was used to analyze the factors influencing the prognosis of children and young osteosarcoma patients after surgery. A nomogram plot predicted 1-, 3-, and 5- survival rate in osteosarcoma. The model's accuracy was validated by the area under the ROC and calibration curves. After PSM, multifactor Cox regression analysis found AJCC Stage III-IV (CSS : HR = 5.26, 95% CI 1.95-14.18, p=0. 001; HR = 5.54, 95% CI 2.56-12.01, p < 0. 001. Limb salvage surgery (CSS : HR = 0.58, 95% CI 0.44-0.77, p < 0. 001) has independent impact factors for CSS prognosis. The survival curve before and after PSM showed that patients with osteosarcoma of children and young adults who underwent limb salvage surgery had a survival benefit compared with those who underwent amputation surgery. Gender, chemotherapy, histology, primary tumor site, stage, and surgical modality were modeled in a total of six variables in the nomogram. The model exhibited good predictive performance. The AUC were 0.823, 0.74, and 0.757 for training set at 1, 3, and 5 years, respectively. The AUC of validation set 0.666, 0.722, and 0.699 at 1, 3, and 5 years, respectively. The model also predicted CSS with good fidelity for both datasets. This model was significantly superior to the 8th edition of the AJCC TNM staging system, with a better net benefit in predicting CSS in children and young adults with osteosarcoma. Limb salvage surgery is an option for children and young adults with osteosarcoma and cancer-specific survival rates can be improved by receiving limb salvage surgery.

Lower-Limb Amputation in Children and Adolescents-A Rare Encounter with Unique and Special Challenges.

Background/Aim: The pattern of lower-limb amputation, indications, complications, and revision in pediatric cases differs globally. Therefore, we conducted this study to describe the patterns of lower-limb amputation at our institution. Methods: During a set period between 2010 and 2020, adolescent patients undergoing lower-limb amputation within the orthopedic department of Heidelberg University Hospital were retrospectively collected and analyzed. The retrieved dataset included two parts: data on lower-limb amputations and data on subsequent complications and revision surgeries at the same time. Besides patients’ general information (age, gender), the dataset included data regarding amputation patterns (number, indications, and level of amputation, complications, and revision surgeries and their indications). Results: Twenty-two patients undergoing lower-limb amputation were examined, of which the majority were males (63.6%) with a mean age of 12 (5.1) years. Tumor was the most common indication for amputation (72.7%), and transfemoral amputation was the most frequent level (68.2%). Complications occurred in 10 patients, mostly due to stump impalement or bony overgrowth. Of all recorded patients requiring revision, nine were regarding bone and one case regarding soft tissue. Conclusions: Lower-limb amputation in adolescents is a rare encounter and it is commonly indicated due to bone tumors. The thigh is the most common level of amputation. Postoperative complications are frequent, mainly secondary to bony overgrowth, and often require revision surgery.

Testicular blood supply and growth in children with high cryptorchidism treated with gubernaculum preserving vs. cutting laparoscopic orchiopexy: A pilot trial

It is still controversial whether the frenum of testis should be retained in laparoscopic testicular fixation. It is a prospective experiment to study testicular preservation on testicular growth in children with high cryptorchidism. From January 2018 to June 2020, 120 children with high cryptorchidism in Inner Mongolia Maternal and Child Health Care Hospital and The Fourth Hospital of Baotou were randomly divided into retention group (60 cases in group P, aged 1-3 years, average 1.85±0.58) and cutting group (60 cases in group C, aged 1-3 years, average 1.75±0.66) (P=0.52). PSV, EDV, RI and testicular volume were measured by color Doppler ultrasound before operation and 1,3,6,12 months after operation. No, there was significant difference between the two groups (P>0.05). There is no significant difference in testicular blood supply and growth between laparoscopic testicular fixation and frenulum amputation in children with high cryptorchidism.

Multidisciplinary Team Support for Psychological Aspect of Osteosarcoma Amputation in Children: A Case Report

Introduction. Osteosarcoma is the most common primary bone tumor in children. The current management is the surgical method (amputation) and continued chemotherapy. When someone is expected to do this treatment, there will be various possible psychological reactions occur. This amputation condition will affect psychological symptoms both before and after the procedure.&#x0D; Case presentation. A girl, Ms. D, seven years old, first grade of elementary school, planned to be amputated with a diagnosis of right tibia proximal osteosarcoma. The patient is a child the second of 3 siblings. The patient was taken to Dr. Soetomo General Hospital, after checking at the hospital in Ponorogo, then a referral was given for further treatment. Patient is referred because the swelling in the right knee is getting bigger day by day. The patient is being treated and will be planned for surgery with a diagnosis of proximal osteosarcoma right tibia. The patient is consulted by a psychiatrist for assistance considering the patient will be carried out right leg amputation surgery.&#x0D; Conclusion.Chemotherapy with various side effects will also have an effect on the psychological condition of the patient. So there is a need for full involvement multidisciplinary in dealing with pediatric patients with osteosarcoma that will be carried out amputation to obtain optimal therapeutic results.

Impact of Level of Pediatric Amputation on Selection of Prosthetic Component Options

ABSTRACT Introduction Amputation is one of the oldest surgeries known to the human race. The principles of amputation in children are different than in adults. Common indications for amputation include congenital, traumatic, infection, malignancy, vascular, and other pathology. Improper prosthetic fitting or inability to use the most modern available prosthesis can lead to dissatisfaction and compromised high-level function. The aim of this study was to assess residual limbs for compatibility to fit the most modern prosthetic components. Methods This study is a retrospective review of medical records of patients who underwent amputation between the pelvis and midfoot before 18 years of age. Age, sex, etiology, and level of amputation were recorded. A senior certified prosthetist graded the limbs based on limitations the residual limb imposed on options for the highest functioning modern prosthetic components. Results Sixty-one patients were identified (35 male, 26 female) with a mean age at assessment of 17.35 years (range, 1.86–35.35 years). Congenital causes and tumors were the most common etiology. Amputations around the ankle were most common (25), followed by transtibial (20). There were 59% grade 1 limbs with no restrictions to component options, 28% grade 2 with moderate restrictions, and 13% grade 3 or severely limited component options due to the residual limb. Most grade 1 residual limbs were transtibial or proximal. Amputations distal to transtibial were of all grades. Conclusions The choices for optimal high-level prosthetic components are much less limited for transtibial amputation than more distal amputations leading to potentially less high-level prosthetic function. Managing the residual limb length and prosthetic fitting ability is an important element in pediatric amputations if the goal is to fit mature young adults with the highest functioning level prosthetic components.

Post release International Scientific and Practice Conference “High low limb amputations in children and adult”

The article presents the chronology of the International Scientific and Practice Conference “High low limb amputations in children and adult” (May 20–21, 2019).

Indications and challenges of limb amputation in children; Experience in a tertiary hospital in Enugu Nigeria

Background: Limb amputations in children are generally an uncommon procedure and are usually associated with significant emotional implications for the patients and their caregivers. Apart from emotional issues, this surgical procedure, which is often life-saving is fraught with challenges in a developing country. The aim of the study was to review indications and challenges posed by presentation and consent time in managing children who need amputation. It is hoped that highlighting the challenges will be helpful in improving care for children who may be involved. Patients and Methods: This was a retrospective study of all children 16 years and below who had limb amputation in Enugu State University of Technology Teaching hospital between January 2015 and December 2019. Results: They were 22 amputations involving 13 (59.0%) males and 9 (41.0%) females, giving a ratio of 1.4:1. Amputations of the lower limb occurred in 15 (68.2%) cases, while the upper limb was involved in 7 (31.8%) cases. Road traffic accident (RTA) 6 (27.3%) and sequalae of Traditional bone setter's (TBS) intervention 6 (27.3%) after trauma were the most common indications for amputation. Delayed wound healing was the most common complication seen. No mortality was recorded, and consent for surgery was the most common challenge encountered. None of the patients was able to acquire prosthesis due to financial constraints. Conclusion: RTA and bone setter's intervention in trauma management leading to gangrene are the most common indications for amputation in children. Comprehensive Child health care plan addressing observed challenges could bring a better outcome in children who may need amputation.

Clinical analysis of replantation of finger degloving amputation in children

Objective To report the clinical treatment and efficacy of replantation of finger degloving amputation in children. Methods From January 2010 to December 2017, 10 cases (12 fingers) of finger degloving amputation were performed replantation in children aged 11 months to 3 years old. The clinical features, surgical precautions and postoperative efficacy of the injuries were retrospectively analyzed. Results Postoperatively 10 fingers survived and 2 fingers died. The postoperative follow-up period was 6 to 12 months. Among them, 2 fingers had mild lateral deformity of distal segment development and 1 finger had hypertrophic scar contracture. The other fingers had good shape and functional recovery. According to the evaluation criteria of replantation function of severed fingers issued by Hand Surgery Society of Chinese Medical Association, the results were rated as excellent in 7 fingers, good in 2 fingers, and poor in 3 fingers. Conclusion The characteristics of finger degloving injury in children are various. Individualized treatment during and after operation can achieve better clinical efficacy. Key words: Child; Replantation; Degloving amputation; Treatment outcome

Factors Impacting Bone Remineralization in Children with Through Knee Amputation

A relationship between bone density and prosthetic use exists among all individuals with lower limb amputations. The selection of suspension in prosthetic design and distal limb weight bearing affect the non‐density of the residual limb. The aim of the study was to identify the factors that impact positive bone remineralization in children with through knee amputation.A systematic review of peer reviewed journals of physical therapy interventions, prosthetic socket and suspension design, and through knee amputations in children was done. Eighteen articles met the inclusion criteria. Bone mineral density loss after an amputation surgery is typical but the extent of loss can be minimized by the multifocal approach of physical therapy with gait training, properly fitting prosthetics with weight‐bearing designs.Physical therapists are crucial to this approach with assessment and training in mobility and gait, especially in children with post amputation. The through knee amputation allows for increased weight bearing as well as the skin fit suspension and socket design. By weight bearing remineralization of lost bone in the residual limb is possible in the patient with through knee amputation.Support or Funding InformationNo funding sources were used.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Iliac crest apophysis transfer to treat stump overgrowth after limb amputation in children: case series and literature review.

Stump overgrowth is the main problem of limb amputation in children. Many surgical procedures have been developed to overcome the problem, but all have shown inconsistent results. The only surgical procedure that has been successful in preventing overgrowth is capping of the amputated limb with a cartilaginous cap taken from the amputated limb, usually from the head of fibula. A donor site is not available in revision cases. Iliac crest apophysis transfer was suggested to treat the condition, but has never been previously reported. The purpose of this study is to review the results of iliac crest apophysis transfer to prevent stump overgrowth. Five children with amputation stump overgrowth underwent iliac apophyseal transfer to cap the resection site of the overgrowth. Retrospective review showed that three of the five suffered recurrent stump overgrowth two to fouryears after the index surgery. All three were revised again. One patient was lost to follow-up. Although many studies showed capping of the stump with cartilaginous cap to be successful in preventing stump overgrowth, iliac crest apophysis transfer was only successful in one of four cases available to follow-up (25%). This is not a reliable enough method to be used routinely.

Thumb Amputations in Children: Classification and Reconstruction by Microsurgical Toe Transfers

Traumatic amputations of the thumb are rare in children compared with adults, but hand surgeons remain reticent to consider microsurgical reconstruction with toe-to-thumb transfers. This study reports the functional outcomes and complications of children with traumatic thumb amputations who underwent toe-to-thumb reconstruction. A retrospective review of children who sustained thumb amputations and whose parents elected for their child to undergo reconstruction by toe-to-thumb transfer was performed. Details of the level of thumb amputation, whether other fingers were also amputated, which toe was transferred on which vascular pedicle, survival of the transfer, and complications, were collected. Opposition, sensation, and growth of the toe-to-thumb transfers was measured. Functional and psychosocial outcomes were evaluated by both the parents and the older children using the Pediatric Outcomes Data Collection Instrument questionnaire. Twenty-one thumb amputations in 19 children between the ages of 2 and 17 years were referred for secondary reconstruction. Ten were isolated thumb amputations and 11 were combined thumb and multiple finger amputations. Two children had bilateral thumb amputations. Twenty-one toe-to-thumb transfers were performed: 14 second toe transfers and 7 great toe transfers (3 great toe and 2 trimmed and 2 Morrison wraparound variations). There were no immediate postoperative reexplorations of the microsurgical anastomoses and all toe transfers survived completely. All children regained pinch and grasp function and sensation. There were no gait problems in the donor feet. Microsurgical toe-to-thumb transfers should be offered as an alternative option to the traditional techniques of distraction lengthening and pollicization, for posttraumatic thumb reconstruction in children for any level of amputation from just distal to the carpometacarpal joint to the interphalangeal joint. Toe-to-thumb transfer provides length, opposition, and sensation without disturbing ambulation and is associated with excellent psychosocial outcomes as evaluated by both parents and older children. Therapeutic IV.

Role of Amputation in Improving Mobility, Pain Outcomes, and Emotional and Psychological Well-Being in Children With Metastatic Osteosarcoma.

Few studies have analyzed the benefit of limb amputations in children with metastatic osteosarcoma and limited life span. We studied outcomes of limb amputations in children with metastatic osteosarcoma. We performed a retrospective review of patients who underwent limb amputations (January 1995-June 2015) and died within 1 year of surgery. We studied 12 patients with osteosarcoma at a single institution. Data on mobility, pain, and emotional and psychological well-being were retrieved from medical records from 1 month before surgery to 6 months after surgery. Of the 12 patients (7 females and 5 males; median age at surgery 13 years [range, 7-20 years]) meeting study criteria, 3 patients and 9 patients had primary osteosarcoma in upper and lower limbs, respectively. Mobility improved postamputation in 8 bedridden/wheelchair-bound patients. Postamputation, emotional, and psychological well-being improved for 9 patients, 3 patients had persistent psychological and/or emotional symptoms, and no patient experienced signs of regret. Daily mean pain scores were significantly lower at 1 week (median 3 [range, 0-6]; P = .03) and 3 months (median 0 [range, 0-8]; P = .02) postsurgery than at 1 week presurgery (median 5.5 [range, 0-10]). Morphine consumption (mg/kg/d) showed a trend toward higher values at 1 week (median 0.2 [range, 0-7.6]; P = .6) and 3 months (median 0.2 [range, 0-0.5]; P = .3) postsurgery than at 1 week presurgery (median 0.1 [range, 0-0.5]). Patients undergoing limb amputations had reduced pain and improved mobility and emotional and psychological well-being. Amputations are likely to benefit children with limited life expectancy.

Composite Grafts for Pediatric Fingertip Amputations: A Retrospective Case Series of 100 Patients.

Fingertip amputations are common. This study reports on the outcomes of composite grafts used for fingertip amputations in children, measuring graft take, predictors of graft take, complications, and patient-reported outcomes. A retrospective case series of consecutive patients (≤ 16 years) undergoing composite grafts for fingertip amputations in a tertiary pediatric hospital, January 06 to December 16, was performed. Information was collected on amputations, graft take, and complications. Logistic regression was used to analyze factors predicting graft take (partial/complete or failure) including age; amputation level; mechanism and time delay to surgery. Patients were contacted via post or telephone to ask about functional and cosmetic outcomes and their perception of graft take. One hundred patients [57 (57%) males; mean age, 4.41 ± 3.98 years], presenting with 100 fingertip amputations, met the inclusion criteria. Amputation mechanism was crush in 75 (75%), avulsion in 13 (13%), and laceration in 12 (13%). Thirteen (13%) composite grafts survived completely, 46 (46%) partially, and 41 (41%) failed. Graft survival was higher in children under 4 years (P = 0.016). Seventeen (17%) grafts became infected, 9 (9%) required a reoperation, 9 (9%) had wound healing complications, and 4 (4%) patients developed psychological complications. Patient-reported survival was 33% higher than medical-reported survival. Cosmetic issues were the commonest complication reported by patients. Patients rated fingertips looking 3.5/5 normal, and that they were 4/5 satisfied with the appearance. Most patients were using their fingers normally by 2-6 months. Composite grafts for fingertip amputations mostly only partially survive, but morbidity is low, patient satisfaction is high, and acceptable cosmetic and functional outcomes are achieved.

Extremity Amputations in Children from Complications of Traditional Bone Setters' Care Seen in a Tertiary Hospital in Port Harcourt, Nigeria

Extremity Amputations in Children from Complications of Traditional Bone Setters' Care Seen in a Tertiary Hospital in Port Harcourt, Nigeria

Fingertip Replantation With Palmar Venous Anastomoses in Children.

Fingertip amputation in children is difficult to manage using microsurgical replantation techniques and many salvage procedures have failed owing to the nonavailability of suitable veins for anastomosis in the fingertip. This study reviewed our experience of pediatric fingertip replantation involving palmar venous anastomoses and evaluated the clinical outcomes. From October 2008 to May 2013, 21 pediatric fingertips that had been completely amputated at or distal to the distal interphalangeal joint of the finger, or at or distal to the interphalangeal joint of the thumb were managed using complete replantation. One artery was anastomosed for revascularization with or without nerve repair, and a palmar venous anastomosis was performed to reestablish the outflow system. Twenty (95.2%) of the 21 fingertips survived. One replant involving an avulsion amputation of the left little finger failed, and the patient underwent stump cap-plasty. Excellent restoration of finger motion, pinch strength, and appearance was observed during the mean 39.9-month (range, 18-65 months) follow-up. The mean regained static 2-point discrimination sensation was 3.8 mm (range, 3.2-4.2 mm). All of the children and their families were satisfied with the surgical outcomes. Successful palmar venous anastomosis appears to promote the survival of replanted fingertips in children. Given that the procedure may simplify postoperative care, minimize complications, and achieve a high survival rate, it should be attempted if the technical expertise is available.

Pediatric Traumatic Amputations in the United States: A 5-Year Review.

Pediatric traumatic amputations are devastating injuries capable of causing permanent physical and psychological sequelae. Few epidemiologic reports exist for guidance of prevention strategies. The objective of this study is to review the recent trends in pediatric traumatic amputations using a national databank. A review of all pediatric (age, 0 to 17 y) amputee patients was performed using the National Trauma Data Bank from 2007 to 2011. Data including demographics, location of amputation, and mechanism of injury were analyzed. In the analysis 2238 patients were identified. The majority of amputations occurred in the youngest (0 to 5 y) and oldest (15 to 17 y) age groups with a 3:1 male to female ratio. The most common amputation locations were finger (54%) and toe (20%). A caught between mechanism (16.3%) was most common overall followed by machinery, powered lawn mowers, motor vehicle collisions, firearms, and off-road vehicles. Males were statistically more likely to have an amputation and lawnmower injuries were statistically associated with lower extremity amputations in children 5 years old and below. Motor vehicle injuries were the most common cause of adolescent amputations. Firearm-related amputations occurred predominantly in adolescents, whereas off-road vehicle amputations occurred in all ages. Common trends in pediatric amputations are relatively unchanged over the last decade. Young children sustain more finger amputations from a caught between objects mechanism, whereas adolescents sustain serious amputations from higher energy mechanisms such as firearms-related and motor vehicle-related injuries. Lawnmower-related amputations continue to most significantly affect younger children despite increased public awareness. Improved prevention strategies targeting age and mechanism-related trends are necessary to prevent these costly and debilitating injuries. Level IV.