Weinstein Lovell and Winters Pediatric Orthopaedics 7e

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CHAPTER 30  |  The Child with a Limb Deficiency

Boys: Lengths of the Long Bones Including Epiphyses a

TABLE 30.3

Femur

Distribution

s d

s m

+2 s d 15.74 19.90 23.15 26.04 28.60 31.10 33.61 35.89 38.23 40.40 42.63 45.01 47.70 49.80 50.71 51.15 51.17 51.15 +2 s d 12.84 16.16 18.66 20.85 22.95 24.96 27.02 28.94 30.91 32.76 34.70 36.82 39.16 40.91 41.61 41.86 41.85 41.80

+1 s d 15.11 19.02 22.12 24.85 27.26 29.60 31.93 34.09 36.29 38.35 40.40 42.57 44.95 46.99 48.20 48.90 49.12 49.19 +1 s d 12.22 15.35 17.72 19.76 21.71 23.54 25.39 27.16 28.95 30.64 32.40 34.29 36.32 38.04 39.00 39.45 39.54 39.54

−1 s d 13.85 17.28 20.06 22.45 24.58 25.58 28.57 30.47 32.43 34.23 35.92 37.67 39.40 41.37 43.19 44.42 45.02 45.27 −1 s d 10.98 13.73 15.86 17.58 19.21 20.87 22.13 23.60 25.02 26.42 27.80 29.21 30.66 32.32 33.76 34.63 34.00 35.04

−2 s d 13.22 16.40 19.03 21.26 23.24 25.08 26.89 28.67 30.49 32.18 33.69 35.23 36.64 38.56 40.67 42.17 42.97 48.31 −2 s d 10.36 12.92 14.92 16.49 17.97 19.46 20.50 21.82 23.06 24.30 25.50 26.68 27.82 29.45 31.15 32.22 32.59 32.78

Number

Age (yr)

Mean 14.48 18.15 21.09 23.65 25.92 28.09 30.25 32.28 34.36 36.29 38.16 40.12 42.17 44.18 45.69 46.66 47.07 47.23 11.60 14.54 16.79 18.67 20.46 22.12 23.76 25.38 26.99 28.53 30.10 31.75 33.49 35.18 36.38 37.04 37.22 37.29 Mean

21 57 65 66 66 67 67 67 67 67 67 67 67 67 67 67 67 67 61 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67 67

1 2 3 4 5 6 7 8 9

0.628 0.874 1.031 1.197 1.342 1.506 1.682 1.807 1.933 2.057 2.237 2.447 2.765 2.809 2.512 2.244 2.051 1.958 0.620 0.809 0.935 1.091 1.247 1.418 1.632 1.778 1.961 2.113 2.301 2.536 2.833 2.865 2.616 2.412 2.316 2.254 s d

0.077 0.107 0.126 0.146 0.164 0.184 0.205 0.221 0.236 0.251 0.276 0.299 0.338 0.343 0.307 0.274 0.251 0.239 0.074 0.099 0.114 0.133 0.152 0.173 0.199 0.217 0.240 0.258 0.281 0.310 0.345 0.350 0.320 0.295 0.283 0.275 s m

10 11 12 13 14 15 16 17 18

Tibia

Distribution

Number

Age (yr)

1 2 3 4 5 6 7 8 9

10 11 12 13 14 15 16 17 18

a Orthoradiographic measurements from longitudinal series of 67 children. From Anderson M, Messner MB, Green WT. Distribution of lengths of the normal femur and tibia in children from one to eighteen years of age. J Bone Joint Surg Am 1964;46:1197, with permission.

better than the use of biologic material (45, 46). Marquardt reported in the mid-1970s, in the German literature, on the capping of the bone end with a cartilage–bone graft. More recently, Tenholder et al. (47) reported comparable results with the use of a polytetrafluoroethylene felt pad. Various reports

for both acquired and congenital amputees indicate generally favorable results, with most revisions being for technical rea- sons (45, 46, 48, 49). When a patient presents with pain and bursa forma- tion, prosthetic modification and other conservative measures