What are limb deficiencies and deformities?
A limb deficiency is when a child is missing part of or all of a leg, arm, hand or foot. Limb deficiencies can be congenital (present at birth) or acquired (the result of disease, an accident or other trauma). Limb deficiencies can affect the whole limb or just part of the limb.
A limb deformity is a misshapen limb. A deformity can affect the appearance and function of upper limbs like the arms and hands, as well as lower limbs like the legs and feet.
Limb length discrepancy
Limb length discrepancy means there are differences in limb lengths. These differences can be caused by limb deficiency problems or complications from broken bone growth plates.
- Failure of formation
- Abnormal formation
- Too many bones and fingers
- Too few bones and fingers
What causes congenital deformities and deficiencies?
We may not always know the reason why a deformity or deficiency exists at birth. The cause for most limb deficiencies is unknown. Some deficiencies happen because of exposure to certain drugs while the baby is in the womb. Other deficiencies may be inherited, although this is rare. For some deformities, there may be underlying bone problems, such as rickets, that can lead to bent bones or osteogenesis imperfecta (brittle bone disease), which can lead to deformities from multiple fractures.
We treat babies, kids and teens who are affected by congenital (present at birth) conditions that cause limb deficiencies and deformities. These conditions can affect upper and lower parts of the body, including:
Acquired limb deformity or deficiency
Some deformities can be acquired, which means it develops over time or happens because of an injury, such as a fracture, or can happen because of an infection or a tumor.
Post-traumatic limb deformity
A post-traumatic limb deformity is a limb that becomes crooked after a bone is broken. In some cases, the bone may heal in a crooked position, which is known as a fracture malunion. Other times, the fracture may heal straight, but the bone’s growth plate is partially damaged. This causes the bone to heal crooked or grow at a different length than the opposite limb.
In children, fracture malunions are often not a problem if the crookedness is not causing any pain or the child can still use the limb normally. This usually happens if the fracture is close to the growth plate but does not affect the growth plate. Infections may also affect a bone’s growth plate.
If your child has recently had a fracture or infection involving the growth plate, your doctor will follow the growth of your child’s limb for at least six to 12 months to determine if there are any problems. Some types of deformities do not need treatment and get better over time. In some children, a crooked bone will not improve its alignment as it grows, and it will become painful or cause functional problems. If this is the case, your child’s doctor can talk to you about options to straighten the bone.
Post-traumatic limb deficiency (amputation)
Our team of experts understands how to deal with traumatic events that may require amputation, rehabilitation and follow-up care. Acquired amputations happen most often as a result of trauma or infections. The majority of amputations happen because of trauma. Our team offers a multidisciplinary approach to caring for children, teens and young adults who need amputations.
Tumors and infections
Some infections may require amputation so that the disease does not spread. Tumors can also result in the need to have surgery on or amputate a limb.
Some types of tumors that may require amputation include osteogenic sarcoma, Ewing’s sarcoma and rhabdomyosarcoma. Your child’s care team will work together to understand the type of treatment that will work best in his case. To determine whether a limb can be saved depends on how aggressive the tumor is, the stage of the tumor, how effective other medical treatments have been and whether there is a good chance the surgeon can remove all of the tumor.
If surgery is determined to be the best approach for treatment, our team offers a range of treatment options as part of our Bone and Soft Tissue Sarcoma Program.