A short residual limb (amputation stump) limits the type and control of prosthesis available. For example, a very short upper tibia may not allow fitting with a below-the-knee prosthesis and may require extension of the prosthesis at the thigh or may function as an above-the-knee amputee. By lengthening of the short tibial remnant, fitting and function as a below-the-knee amputee can be achieved. The same is true for a patient with a short forearm stump. The remaining radius and ulna bones can be lengthened to permit below-the-elbow prosthetic fitting. Short femoral remnants can limit the ability to fit an above-the-knee prosthesis. The more awkward, heavier, and less functional hip disarticulation prosthesis may be required. Bilateral short femur amputees also have sitting balance problems. Lengthening of the short residual femur will facilitate above-the-knee prosthetic fitting. This treatment in bilateral amputees improves sitting balance as well.
This 20-year-old woman suffered bilateral high femoral amputation after being crushed by a truck. We performed bilateral simultaneous lengthening over nails. The femoral length was increased by 15 cm on one side and 17 cm on the other (6 and 7 in, respectively). After recovering from the treatment, the patient was able to better use above-the-knee prostheses to walk. Because of the improved sitting balance, she was able to take up disabled skiing and is currently on the United States Disabled Olympic Ski team competing in Salt Lake City in 2002.