Marked bone spur formation in a burn amputee patient.

This report presents an unusual case of a lower extremity burn amputee with a marked degree of bone spur formation. A 17-year-old man suffered 56% body surface area mixed-depth electrical and flame burns, necessitating left below knee amputation. He was admitted to a rehabilitation center 3 months postinjury for pylon fitting and gait training. Difficulty was encountered with poor skin tolerance to weight bearing because of the prominent distal bony margins in the stump. X-rays of the stump revealed a marked degree of linear bone spur formation, extending longitudinally from the distal tibia and fibula with multiple cross-bridges. The spur formation was considered an extensive bony exostosis of unclear etiology. Surgical revision was elected to obtain a stump more suitable for prosthetic tolerance, and to avoid a bulky "bypass" prosthesis. This stump revision enabled the patient to attain independent functional prosthetic ambulation. Although there is evidence of some recurrence of bone spur formation, this remains limited and asymptomatic.