OSSEOUS OVERGROWTH AFTER AMPUTATION IN ADOLESCENTS AND CHILDREN

We retrospectively studied the incidence of primary surgical revision for stump overgrowth in a population of childhood and adolescent amput ees. The anatomic location and the etiology of amputation are critical to the occurrence of overgrowth needing revision. Metaphyseal-level a mputations are the most likely to develop overgrowth requiring revisio n (50%), whereas diaphyseal amputations are slightly less likely (45%) . Joint disarticulations never develop overgrowth. Traumatic amputatio ns are the most frequent mode of injury requiring revision of overgrow th (43%), followed by congenital or intrauterine amputations (30%) and elective amputations (20%). Radiographic classification of the osseou s overgrowth helps define its severity and degree of ossific progressi on. Surgical revisions are usually performed when overgrowth reaches a grade 3 classification. The majority of skeletally immature diaphysea l- or metaphyseal-level amputees, including those with certain preexis ting orthopaedic conditions, retain the ability to develop osseous ove rgrowth at the apex of the stump skeleton.