Railyard amputations in children.

Railyard or train-related accidents are a common cause of traumatic amputations in children. Four consecutive children with traumatic lower extremity amputations due to railyard amputation seen between 1975 and 1980 demonstrated: a common mechanism of injury--all were attempting to obtain rides on slow-moving trains near their homes or school; similar lower extremity amputation patterns--four right below knee and two left Syme's amputations; and distinctively abnormal psychosocial backgrounds. The psychosocial abnormalities have been demonstrated to be unique in children sustaining traumatic railyard amputations and are probably contributory. Awareness of these factors is important when considering surgical intervention and in planning for long-term rehabilitation.