Deficiencies of the lower limb are less frequent than deficiencies of the upper limb, but surgical and reha­bilitation management may be more involved.

Most of the common lower limb anomalies are longitudinal deficiencies. Despite the complexity of the early inter­vention, lower limb prostheses generally have high acceptance rates.

Surgical intervention is often required to correct the deformity or provide a functional lower limb. This is the most challenging aspect of the early manage­ment of these children. Parents are often faced with difficult decisions of choosing among such surgeries as foot ablation, angulation osteotomies, epiphysiodeses, limb lengthening, and rotationplasty. In addition to the usual risks of surgery and uncertain outcome, eth­nic and religious barriers are important in family deci­sions. Parents may benefit by meeting other families who have faced similar situations. This may ease the discomfort of the decision making for the parents and child (105).