Stump overgrowth in juvenile amputees.

Stump overgrowth requiring surgical revisions occurred in 58 of 1,015 (5.7%) skeletally immature patients with congenital and acquired amputations. Acquired below-knee amputation was the most common type needing revision (18.5%), and the congenital group not requiring a conversion had the least overgrowth problem (1.7%). When the primary amputation occurred after the age of 12 years or when disarticulation was carried out, revisions were unnecessary. The younger the patient, the greater the incidence of repeated revisions. Study of the histological changes in eight juvenile congenital and acquired amputees revealed two patterns: reactive connective tissue stratification and a bursa.