Securing the right prosthetic for a child is a very important decision that affects their quality of life. This article outlines some steps for choosing child prosthetics, understanding your options, handling costs, and keeping your child’s independence and development at the forefront. From the initial stages of recognizing limb differences to lifelong management, you’ll gain clear insights to assist your child in life with their prosthetic.

Understanding Limb Differences in Children

Limb differences in children can occur as a congenital limb difference, at birth, or be acquired later in life due to factors such as injury or illness. While the exact cause of most congenital limb differences remains unknown, hereditary factors and certain environmental exposures during pregnancy are known to increase the risk. On the other hand, acquired limb differences may result from physical trauma, infections leading to necrosis or amputation, and the removal of limbs due to benign or malignant tumors. In some cases, these differences can specifically involve a lower limb difference.

Coping with a limb difference is not a journey walked alone by the child. It impacts the whole family, necessitating a supportive environment for adjusting to these changes. A thorough understanding of the causes and types of limb differences enables you to provide the necessary care and support for your child.

Types of Pediatric Prosthetics

Pediatric prosthetics are not one-size-fits-all. Each prosthetic is tailored to fit the individual needs and activity levels of the child. From upper to lower extremity prosthetics, the options vary significantly to cater to your child’s unique circumstances.

Upper Extremity Prosthetics

Upper extremity prosthetic solutions, including prosthetic arm options, encompass a range of choices from partial or full finger and hand replacements to below-elbow and above-elbow solutions for individuals with upper limb difference. For infants and very young children, passive prosthetics are typically the first choice. These devices, designed for appearance and stabilization, foster early integration into their body image and daily life, encouraging acceptance of the prosthesis from a tender age.

As children grow, they can then graduate to active prosthetics. Body-powered devices utilize cables and harnesses operated by the child’s movements. In contrast, myoelectric prostheses function through batteries and respond to electrical signals from muscle movements. For older children, advanced grip options offer multi-articulating capabilities, now available in sizes suitable for children and teens.

Lower Extremity Prosthetics

Lower extremity prosthetics can include:

• Customized prosthetic sockets tailored to the child’s comfort and the alignment of their residual limb
• Prosthetic feet that consider the child’s weight and size, offering designs to best support their individual mobility requirements
• Prosthetic feet that come in active, everyday, specialty, and rigid designs to accommodate different activity levels and mobility needs.

The choice between microprocessor knees for advanced mobility or more stable mechanical non-microprocessor knees depends on the child’s safety and functional needs. Pediatric lower extremity prosthetics cater to a variety of limb differences, each designed to enhance mobility in its unique way.

The Process of Obtaining a Prosthesis for Your Child

The process of securing a prosthesis for your child is gradual, initiating with research and consultation with your child’s physician to explore suitable treatment avenues. You’ll need to familiarize yourself with the terminology used in prosthetics and the types of devices that could help your child reach their goals.

Once you’ve done your homework, schedule an initial consultation with a clinical prosthetist to discuss the available prosthetic options. This can be followed by an informational meeting, either in-person or online, with a prosthetic care provider to create a prosthetic rehabilitation plan. If geographical distance or personal preference makes in-person consultations challenging, consider remote telehealth visits.

After the prosthetic care provider completes the evaluation, which involves the child’s physician and insurance carrier for authorization, the fitting process for the initial prosthesis can commence, accompanied by appropriate training from clinical therapy specialists. It is important to remember that continuous support and adjustments from the prosthetic provider will be necessary as your child grows and their lifestyle changes. Multiple sockets will be made each year as your child grows.

The Importance of Family Support

Family support acts as a hidden framework, holding together a child’s journey with prosthetics. Parents support their children’s adjustment to prosthetics by:

• Working with pediatric prosthetists to personalize the devices
• Providing day-to-day encouragement for their use
• Developing coping resources and emotional support strategies to manage the initial emotional experiences related to their child’s prosthesis use.

Parents have a key role in handling and interpreting social reactions to their child’s limb difference, equipping them with strategies to manage social inquiries and interactions. Ultimately, the family’s approach and responses to a child’s prosthetic use significantly influence the overall success of rehabilitative care and the child’s well-being.

Funding and Financial Assistance for Child Prosthetics

Though the path to acquiring a prosthesis might feel daunting, there exists a silver lining. Several funding sources and financial assistance programs are available to help cover the costs of pediatric prosthetics. These include:

• Funds from the National Institutes of Health
• The US Department of Defense Congressionally Directed Medical Research Programs
• The US Department of Veterans Affairs Office of Research and Development

There are also organizations which can help with providing prosthetics for free.

Benefits of Prosthetics for Children

Prosthetics extend beyond providing physical support, playing a crucial role in the emotional and social development of a child. Children with limb differences, including children born with such conditions, benefit from improved mobility through the use of lower limb prosthetics, which are tailored to accommodate growth and enable participation in a variety of physical activities. For infants and very young children, passive prosthetics facilitate early integration into their child’s body image and daily life, leading to better utilization and exploration as they grow.

Beyond mobility, prosthetic devices empower children by:

• fostering independence
• allowing them to perform various tasks on their own without the need for constant assistance
• contributing to increased self-esteem as children realize their capability to independently participate in activities and overcome challenges.

Furthermore, the ability to engage with peers in play and various activities, provided by their prosthetic limbs, enhances social inclusion and helps in forming meaningful social connections.

Common Complications and How to Avoid Them

Despite the numerous benefits of prosthetics, potential complications cannot be overlooked. Bony overgrowth and stump impalement following pediatric lower-limb amputations are common. However, proper surgical techniques and postoperative management can minimize these, reducing the need for revision surgeries. The fit of the prosthetic socket is also crucial to prevent skin and tissue issues.

Skin complications, including breakdown and infection, are serious issues in pediatric prosthetic users that necessitate evaluation and prompt treatment by healthcare professionals. To mitigate potential complications, frequent office visits and monthly progress monitoring are essential, especially due to children’s rapid growth and limited communication abilities.

Replacing and Upgrading Your Child's Prosthesis

Similar to outgrowing their shoes, children will inevitably outgrow their prostheses. Children need to get a new lower-limb prosthesis every year up to the age of 5. After that, they require a new prosthesis every two years until the age of 12, and then the frequency decreases to every 3 to 4 years until the age of 21. Adjustable sockets with lacing closure systems help accommodate a child’s rapid growth, but periodic adjustments and resizing may still be necessary.

A prosthesis may need to be replaced if the child’s weight exceeds the safety range of the prosthesis’ components or if it’s no longer functioning as intended. Additionally, an upgrade may be required when the child’s activity level changes significantly, affecting their energy efficiency.

Encouraging Independence and Self-Care

As parents, it is natural to want to do everything for your child, but it’s equally important to foster independence. Establishing a routine is vital to promote the regular use of a prosthesis in a child’s daily activities, crucial in nurturing independence and encouraging self-care.

Children should also be taught to clean all prosthetic components, as this prevents skin complications such as blisters and infections. Encouraging children to actively participate in putting on and removing their prosthetic device, and personalizing it with preferred images or colors, can make them more excited and comfortable with their prosthetic, promoting their independence in care and management.

Finding Support and Role Models

The journey with a prosthetic limb can evoke a mindful of emotions, but remember, you and your child are not alone in dealing with a missing limb. Role models who have achieved success, such as professional athletes with limb differences like Jim Abbott, can have an inspirational impact on children with prosthetic limbs.

Organizations such as the High Five Project create supportive environments and organize special events that recognize and include children with limb differences, providing a sense of belonging. Peer support through groups like the Lucky Fin Project shows children that they are not alone and that others share similar experiences.

Participating in Sports and Activities with Prosthetic Limbs

A prosthetic limb should not deter your child from engaging in sports and activities. In fact, custom activity-specific prosthetic devices can help children participate in a wide variety of interests, from playing musical instruments to participating in sports. For instance, devices like a Basketball Prosthetic Hand have been engineered to assist children in playing basketball, enabling effective dribbling, passing, and shooting.

Activity-specific prosthetic attachments are beneficial from an early age, fostering sports participation and encouraging physical and social development.

Frequently Asked Questions

What age can a child get prosthetics?

Children can generally be eligible for prosthetics at around 9-12 months, when they are able to pull up to stand. It can also be helpful for children born without fully-formed limbs, who may receive their first prosthetic between 6-18 months old.

What are the 4 types of prosthesis?

The four main categories of prosthetic devices are transradial, transhumeral, transtibial, and transfemoral, and each serves a different function depending on the missing body part.

What is a pediatric prosthetic?

A pediatric prosthetic is an artificial device, such as a limb, that helps children regain function in a missing body part, enabling them to pursue their dreams and reach their full potential using advanced, lightweight technologies.

How much does a child prosthetic leg cost?

The cost of a child prosthetic leg can range from around $5,000 for basic models to as high as $70,000 for advanced, computerized prosthetics, depending on the type and insurance coverage.

When should I start looking into prosthetics for my child?

You should start researching prosthetic devices and consulting your child's physician about suitable treatment approaches as soon as the need arises. It's important to address this issue promptly and seek professional guidance.