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OBJECTIVES

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At the end of this chapter, all students are expected to:

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  1. Classify congenital amputations according to International Standard Organization terminology.

  2. Differentiate between congenital and acquired amputations in relation to

    1. The residual limb

    2. Developmental effects

    3. Rehabilitation program

  3. Discuss the role of the family in working with children with amputations.

  4. Develop an assessment program for a child with a unilateral amputation.

  5. Develop an intervention program for a child with a unilateral amputation.

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CASE STUDIES

Michael Donnagin is a 6-month-old boy brought to the clinic by his mother. Michael was born with only half a humerus on the right side and only the medial two toes on the right foot. The rest of the extremities are normal. He is an only child. His father is a loan officer at a bank, and his mother is on leave from her job as a legal secretary.

Jenny Smith, 6 years old, had a left transfemoral amputation secondary to a farm accident 4 weeks ago; an attempt was made to reattach the limb, but it failed. She was discharged from the hospital about 4 days after the amputation and has been at home with visiting physical therapy and nursing services. She is referred to an amputee clinic for evaluation and treatment. She lives with her parents and four older siblings on a moderate-size dairy farm about 60 miles from the city.

Case Study Activities
  1. Classify Michael's amputations using appropriate terminology.

  2. Compare and contrast acquired versus congenital amputations.

  3. Determine the appropriate practice pattern(s) for each child.

  4. Using the practice pattern as a guide, develop an appropriate examination plan for each child.

    1. What critical data do you need that can best be obtained through interview?

    2. What critical historical data do you need?

    3. What tests and measures would you perform today? Why?

    4. What might be the parents' concerns at this time?

    5. What information would you like to have from the parents?

  5. Compare and contrast the prosthetic rehabilitation program for each of these children and an adult with a similar disability.

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The habilitation of children with single or multiple limb loss is a complex, long-term process involving specialists from many disciplines with training in pediatric care. This chapter provides a brief overview of this topic, offering general guidelines for the therapist who may occasionally work with a child who has lost one limb. Most physical therapists and physical therapist assistants, knowledgeable in the prosthetic care of adults as well as normal development, can provide effective therapy to a child with one limb loss. The care of the child with multiple limb deficiencies requires considerable expertise by all members of the team, and such children should be referred to special pediatric centers for optimum care.

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A child is not a miniature adult. Children have special problems related to developmental tasks, parental adjustment, and adjustment and acceptance of the artificial limb. The rehabilitation program involves the whole family, and the attitudes of ...

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