MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCE

TANZANIA TRAINING CENTRE FOR ORTHOPAEDIC TECHNOLOGIST

 STUDENT NUMBERS: 27/24

YEAR : 2018/2019

CASE : CONGENITAL AMPUTATION BELOW THE KNEE

DATE : 12th AUGUST 2019

CONGENITAL AMPUTATION BELOW THE KNEE

PRESENTATORS

27 and 24

PRESENTATION LAYOUT

• Definition

• Causes

• Classification

• Diagnosis

• Treatment

• Risk Factors

• Prevention

Definition
 • Congenital amputation is the absence of a fetal limb or fetal part at birth. This condition
may be the result of the constriction of fibrous bands within the membrane that
surrounds the developing fetus (amniotic band syndrome) or the exposure to
substances known to cause birth defects (teratogenic agents). Other factors, including
genetics, may also play a role.

•
Causes

• The exact cause of congenital amputations is unknown. However, most birth defects
have one or more genetic factors and one or more environmental factors. It is also
known that most birth defects occur in the first three months of pregnancy, when the
organs of the fetus are forming.

Classification

• There are two classes of congenital amputation:

• Longitudinal.

• Transverse.

Longitudinal.

• Involve specific maldevelopments (example : complete or partial absence of the radius,

fibula, or tibia). Radial ray deficiency is the most common upper-limb deficiency, and
hypoplasia of the fibula is the most common lower-limb deficiency.

Transverse.
 • All elements beyond a certain level are absent, and the limb resembles an amputation
stump. Amniotic bands are the most common cause the degree of deficiency varies
based on the location of the band, and typically, there are no other defects or
abnormalities.

Example of transverse amputation includes:

• Tetra-amelia for the absence of all four limbs.

• Meromelia, which is the partial absence of a limb or limbs.

Tetra-amelia Meromelia

Diagnosis

• Many cases of congenital amputation are not diagnosed until the baby is born.
Ultrasound examinations may reveal the absence of a limb in some developing fetuses,
but routine ultrasounds may not pick up signs of more subtle defects. However, if a
doctor suspects that the fetus is at risk for developing a limb deficiency (for example, if
the mother has been exposed to radiation), a more detailed ultrasound examination
may be performed.

Treatment

• Successful treatment of a child with congenital amputation involves an entire medical

team, including a pediatrician, an orthopedist, a psychiatrist or psychologist, a
prosthetics (an expert in making prosthetics, or artificial limbs), a social worker, and
occupational and physical therapists. The accepted method of treatment is to fit the
child early with a functional prosthesis because this leads to normal development and
less wasting away (atrophy) of the muscles of the limbs present. However, some parents
and physicians believe that the child should be allowed to learn to play and perform
tasks without prosthesis, if possible. When the child is older, he or she can be involved
in the decision of whether or not to be fitted for prosthesis.
Risk Factors

• Smoking

• Drinking alcohol

• Poor diet

Prevention

• Prevention of birth defects begins with building the well-being of the mother before
pregnancy. Prenatal care should be strong and educational so that the mother
understands both her genetic risks and her environmental risks. Several disciplines in
alternative therapy also recommend various supplements and vitamins that may reduce
the chances of birth defects. Multivitamin including folic acid