Late surgical management of residual limb and ischemic contracture complications in pediatric earthquake survivors
Öz
Purpose: This study aimed to evaluate late extremity complications and the surgical management strategies used in pediatric patients who developed residual limb problems or ischemic contractures following the February 6, 2023 Kahramanmaraş earthquake.
Materials and Methods: This retrospective observational study included pediatric patients who underwent surgical treatment for amputation stump complications or ischemic contractures secondary to compartment syndrome. Demographic characteristics, complication types, surgical procedures, number of operations, and infection rates were analyzed.
Results: A total of 18 pediatric patients were included, with a mean age of 14.28±5.42 years. The most common late complications were soft tissue insufficiency (33.3%), pressure ulcers (27.8%), and osseous overgrowth (22.2%). Patients with stump-related complications were significantly younger than those with ischemic contractures (12.25±5.34 vs. 18.33±2.73 years). Stump complications were primarily managed with revision procedures, whereas ischemic contractures more frequently required reconstructive procedures, including tendon release, tendon transfer, and metatarsal extension osteotomies.
Conclusion: Late extremity complications in pediatric earthquake survivors show distinct clinical patterns depending on the initial injury and treatment strategy. Amputation stump complications often require revision surgery, whereas ischemic contractures are more commonly managed with reconstructive procedures aimed at restoring functional alignment and improving weight distribution.
Anahtar Kelimeler
Earthquakes, Amputation, Traumatic, Child, Contracture, Ischemic, Compartment Syndromes
Kaynakça
- Uluöz M, Gökmen MY. The 2023 Turkey earthquake: management of 627 pediatric musculoskeletal injuries in the first month. Children. 2023;10:1733.
- Basaran S, Sariyildiz A, Olmez S, Kundakci B, Bicer OS. Prosthesis applications and challenges in children with earthquake-related amputations. Injury. 2024;55:111920.
- Emsieh S, Terro K, Rabay C, Ibrahim A, Atiyeh B. Surgical burden of traumatic lower limb amputations in the pediatric age group. Ann Burns Fire Disasters. 2023;36:337-46.
- Khan MA, Javed AA, Rao DJ, Corner JA, Rosenfield P. Pediatric traumatic limb amputation: the principles of management and optimal residual limb lengths. World J Plast Surg. 2016;5:7-14.
- Griffet J. Amputation and prosthesis fitting in paediatric patients. Orthop Traumatol Surg Res. 2016;102:161-75.
- Tang H, Zhang SC, Tan ZY, Zhu HW, Zhang QL, Li M. Functional reconstruction of ischemic contracture in the lower limb. Chinese Journal of Traumatology - English Edition. 2011;14:96-9.
- Horsch A, Gleichauf S, Lehner B, Ghandour M, Koch J, Alimusaj M et al. Lower-limb amputation in children and adolescents-a rare encounter with unique and special challenges. Children (Basel). 2022;9:1004.
- Heszlein-Lossius HE, Al-Borno Y, Shaqqoura S, Skaik N, Giil LM, Gilbert M. Life after conflict-related amputation trauma: a clinical study from the Gaza Strip. BMC Int Health Hum Rights. 2018;18:34.
- Yiğit N, Yavuz İA, Aydın T, Güven Ş, Çağlar C, Bozkurt İ et al. Functional outcomes and mortality after multi-limb amputations following the 2023 Türkiye earthquake: a two-year follow-up study from a level I trauma center. J Orthop Surg Res. 2025;20:802.
- Jahmani R, Robbins C, Paley D. Iliac crest apophysis transfer to treat stump overgrowth after limb amputation in children: case series and literature review. Int Orthop. 2019;43:2601-5.
