Review of Long-Term Sequelae and Management in Paediatric Lower Limb Replantation

• Published in: The journal of hand surgery Asian-Pacific volume Vol. 29; no. 6; p. 579
• Main Authors: Ho, Xin Nee, Liao, Janice Chin-Yi, Puhaindran, Mark E, Chong, Alphonsus K S
• Format: Journal Article
• Language: English
• Published: Singapore 01.12.2024
• Subjects: Amputation, Traumatic - surgery; Child, Preschool; Humans; Leg Length Inequality - etiology; Leg Length Inequality - surgery; Lower Extremity - surgery; Male; Replantation - methods; long-term sequelae; Paediatric; Limb length discrepancy; Lower limb amputation; Replantation
• ISSN: 2424-8363
• DOI: 10.1142/S2424835524720172

Major limb amputation in a child is a rare but devastating injury associated with significant psychosocial and financial burden. This, combined with the higher growth and remodelling potential despite segmental limb loss, decreases the threshold for replantation in children. Advances in microsurgical techniques and a better understanding of such injuries have led to lower limb replantation becoming a feasible option, with good long-term functional outcomes, even in bilateral amputations. However, long-term sequelae such as limb length discrepancy (LLD) are common, and patients are often subject to multiple surgical interventions. We present a case of replantation in a 2-year-old child following traumatic right below knee amputation, followed up over a period of 5 years. After multiple surgeries, the patient gained good functional recovery and sensibility of the replanted limb. We reviewed and discussed the management of subsequent long-term sequelae, including LLD, lower limb contractures and valgus deformity. Level V (Therapeutic).