Limb Deficiency
Pediatric-onset limb deficiency is not uncommon, with 4/10,000 in upper extremity congenital limb deficiency alone. In addition, lower extremity hemimelia, traumatic amputations, and childhood cancers are associated with pediatric limb deficiency.
Very little is known about aging with this disability. However, certain comorbidities and secondary conditions are typical for this group (see Table 15.2). Weight control is important to prevent osteoarthritis (169,170). One author describes increased velocity and lower effort in elderly amputees if a locked knee is used (171). Changes in gait or use of upper limb prostheses with aging in this population may be due to a variety of typical disorders of aging, including arthritis, sensory deficits, muscle weakness, or heart disease. Typical surveillance for these disorders is important to maintain ambulation status.
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