Congenital Lower Limb Deficiency is uncommon and management requires a multi-disciplinary approach involving surgeons, physiatrists, prosthetists and therapists. The overall approach involves surgical intervention or prosthetic replacement, often both in varying degrees. Increasingly amputation surgery is being considered as the preferred option to allow benefits from advances in prosthetic technology.
The last 2 decades has seen various developments in prosthetic technology. This includes newer materials with introduction of silicon liners for improved comfort/suspension. Customisable finishing on sockets has made prosthetic limbs more acceptable and appealing. This is accompanied by greater acceptability of disability in our society. New Structural components has made endoskeletal build possible, like in adults. This includes ease of alignment alterations and height adjustment. We recognise newer componentry with more advanced knees units with hydraulic control, energy storage feet and increasing popularity of special prosthesis for sports and leisure.
Clinical management and rehabilitation plans were generally to avoid surgery unless necessary and use basic extension prosthesis when required. Earlier studies showed greater satisfaction with extension prosthesis but with improvement is technology and acceptance of disability in society, limb ablation surgery has allowed improved function. Decision making is more complex and specialised intervention prompts the practice of an integrated specialised clinics to achieve best results. These clinics also provide a tertiary role of supporting services nationally. Family choice and participation is essential and the treatment option must consider all factors when planning the rehabilitation for any specific child. Recent studies support this approach as the preferred treatment option.
Statement of the objective / learning objectives
Congenital Limb Deficiency is uncommon. Management involves specialised multi-disciplinary rehabilitation. Decision making is complex especially with current changes secondary to advances in prosthetic technology. The course presents current approach and role of tertiary centres.