Uncommon Lower-Limb Deficiencies
A few of the less common lower-limb deficiencies that may be seen in the clinic include those resulting from amniotic band syndrome, central ray syndrome, Robert's syndrome, and sacral agenesis.
The amniotic banding can occur at any level, but has been frequently seen to cause auto-amputation at the transtibial level (24). The critical factor in working with and fitting these children is keeping in mind that the likelihood of bony overgrowth is great as a result of the banding occurring at the diaphyseal level. Central ray syndrome and Robert's syndrome have autosomal-dominant inheritance. They can present with a wide array of lower limb anomalies. The result of these presentations and subsequent surgeries will vary. It should be noted that in the case of Robert's syndrome, maintenance of range of motion should be stressed to prevent severe limb contractures; these contractures can affect both fit and function in prostheses. Sacral agenesis is a frequent cause of hip disarticulation or hemipelvectomy; they are difficult to address from the standpoint of a functional prosthetic fitting.
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- Agrawal M.. Textbook of Pediatrics. 3rd ed. — CBS Publishers,2025. — 973 p., 2025
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