Pediatric major lower limb absence: demographics of children accessing 3 prosthetic rehabilitation centers in Cambodia.

BACKGROUND

Demographic and clinical characteristic data for children with major lower limb absence provide insight for rehabilitation professionals and policy makers. This paper describes demographics for children accessing 3 prosthetic rehabilitation centers in Cambodia. It is hypothesized that associations exist between the demographic data and reason for limb absence and time to first prosthetic access.

METHODS

A retrospective analysis of 71 physical casefiles was conducted for children aged 5-17 years in 3 centers affiliated with Exceed Worldwide and the Department of Prosthetics and Orthotics Cambodia between 2005 and 2023. Demographic data were extracted for children with major lower limb absence proximal to the ankle joint. Descriptive and inferential statistics were applied with the significance level set at ( p < 0.05).

RESULTS

Most children were male (67.6%) and 55.3% of prostheses provided were for transtibial. The most common cause was trauma (59.2%) primarily because of road traffic accidents (71.4%). There was a significant association between reason for limb absence with sex ( p = 0.004) and time to prosthetic access ( p = 0.011). Reason for limb absence ( p = 0.016) and age of acquired limb absence ( p = 0.003) were significantly associated with the type of prosthesis supplied.

CONCLUSIONS

Traumatic amputation was the most common, with more males and transfemoral children presenting with trauma than expected, necessitating further research into policies to reduce traumatic amputation and its subsequent proximal amputations. Time to first access was greater for congenital deficiencies necessitating future work to support early prosthetic use. The dataset provides clarity on a unique cohort requiring ongoing prosthetic care.