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PUBLISHED:
April 10, 2023
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by
Eddie Zepeda

Everything You Should Know about Pediatric Prosthetics

Kids Prosthetics

Primecare Orthotics & Prosthetics is here to assist you in making the best decision regarding child amputee prosthetics. If your child has lost a limb or been born without one, custom pediatric prosthetics may be a part of their medical treatment.

In this blog, our team will provide you with the necessary information on prosthetics made for children, so you can make an informed decision to ensure your child remains healthy and content as they mature.

The Main Types of Prosthetics for Children

Prosthetic devices come in various types to assist those with physical disabilities. Active devices feature motors and electronics to enable more natural and precise movements, while passive devices provide stability and balance. Prosthetic hands are generally passive, while prosthetic feet and ankles are used to provide additional support.

Upper Extremity Pediatric Prosthetics

prosthetics made for children

There are many types of prosthetic arms for children. Depending on where a child's prosthetic arm is fitted and how it works, upper extremity prostheses are further classified into:

  • Transradial prosthesis - covers both the forearm and the wrist and is worn on the arm below the elbow.
  • Transhumeral prosthesis - an artificial limb that replaces an arm from the elbow up, connecting to the remaining portion of the arm through straps and cuffs. Although there have been some improvements, transhumeral arm prosthetics for children don’t fully replicate natural movements.
  • Passive prostheses - often prescribed as the first prosthesis for infants, passive prostheses mainly enhance the cosmetic appearance of limb deficiencies. Even though they don't aid active motion, they provide a surface to stabilize objects, significantly improving functionality.
  • Body-powered prostheses - these devices use cables and harnesses to direct limb movement. Wearers mechanically control their new prosthetic using the motion from other parts of their bodies.
  • Myoelectric prostheses - Battery-powered prostheses receive cues from electrical signals from a patient's muscle movements.

Note that ​​not all prosthetic arms for children have hands. Many prosthetic arms for children are designed with a hook or other grip device instead of a hand.

Lower Extremity Pediatric Prosthetics

prosthetics for children challenges

There isn't a one-size-fits-all approach to choosing a prosthetic leg for your child. Various pediatric prosthetics bk types, components, and designs exist based on your child's amputation and activity level.

A child bk prosthetic socket covers the residual limb and can be customized to your child's comfort and functionality needs. Suspension, which refers to how the prosthesis stays in your child's body, can vary depending on the child's size, weight, and daily activity level.

For prosthetic knees, there are two options: microprocessor and non-microprocessor. Microprocessor knees are computerized, battery-powered, and use technology to improve mobility and walking. Non-microprocessor knees have well-designed mechanical components for safety and stability when walking and standing.

Then you will also need to choose your child's prosthetic foot (active, everyday and specialty, and rigid), which also depends on their activity level. There are also different types of partial foot prosthetics available as well.

Helping Your Child Find the Perfect Prosthesis

types of prosthetics arms for children

Whether you need to get prosthetic feet for your child or a prosthetic arm for your child, finding the best solution is more or less the same.

  • Start with a professional evaluation: An orthopedic doctor or prosthetist will assess your child's needs and recommend the best type of prosthesis.
  • Consider their activity level: Consider the type of activity level your child is comfortable with and their age. For instance, an active child needs a more durable prosthesis than a young child learning to walk.
  • Research different prosthesis types: Learn more about the prostheses available to determine which ones meet your child's needs.
  • Factor in your budget: When looking to purchase a prosthesis, take your budget into account. Also, check with your insurance provider if they offer complete or partial coverage. Several organizations provide grants to help cover the cost of prosthetics if you need more financial assistance.
  • Get your child involved: Ask your child what they think about the different prostheses they try on. They may have an opinion on what looks and feels the best. Get their input and make sure they feel comfortable with the prosthesis. Kids with prosthetics feel happier when they’re given agency during the selection process of their prosthetics.

Understanding the Differences Between Adult and Pediatric Prosthetics

Adult prosthetics are typically made of durable materials (metal, plastic) and are custom-fitted to patients. In contrast, pediatric prosthetics are usually made of lighter materials (foam, silicone) and designed to accommodate a growing body. Additionally, they often have colorful patterns to make them more appealing to kids.

Remember, children with prosthetics outgrow their devices as they outgrow a pair of shoes. Therefore, your child's prosthetic must fit them properly to support their mobility, function, and growth. Our team has a wealth of experience with pediatric prosthetics, so you can trust us to make sure your child has the right prosthetic for them.

How Young Can a Child Get Prosthetics?

children's prosthetic leg

Generally, children who can pull up to stand, typically around 9-12 months, should start using a prosthetic as soon as possible to become accustomed to it as they grow. Their prosthetic should be changed once a year or more so long as it performs in alignment with their changing needs.

For children with above-knee amputations, using an unlocked pediatric knee is generally not recommended until they are 3-4 years old. In contrast, those with bilateral above-knee amputations may want to wait until they are six or older before getting their first prosthetic.

5 Benefits of Prosthetics for Kids

Besides the obvious benefits of increased mobility, prosthetics can be an invaluable tool for children who have lost a limb, allowing them to reclaim their self-worth and self-confidence.

#1 Increased Mobility

One of the most significant advantages of prosthetics is the versatility they offer. Lower extremity prosthetics are especially beneficial as they allow children to move around as they would with a real limb.

Upper extremity prosthetics also provide increased mobility. Prosthetics enable more freedom of movement throughout the day, which leads to the second advantage of prosthetics for children: independence.

#2 Autonomy

Although it may be difficult to accept, children need to be self-sufficient. This benefits not only their development as adults but also their emotional well-being. By allowing them to take on tasks and responsibilities, they learn valuable skills that will contribute to their success in the future. Moreover, they will not have to rely on their parents for the rest of their lives.

#3 Greater Comfort

Prosthetics have vastly improved the movements they enable and facilitate. For children who lack the physical capabilities to do simple activities, this can be an extremely rewarding experience.

With prosthetics, they can perform these motions more naturally and comfortably. Our daily routines are composed of a series of movements that we repeat regularly. Helping a child find a smoother, more enjoyable way to move will significantly improve their quality of life.

#4 Belonging

Children need to be able to socialize; however, this can be challenging if they cannot participate in activities with other kids their age. Prosthetics can help children who feel excluded to join in on their classmates' fun. They can participate in the same activities as everyone else, allowing them to exercise physically and create relationships with their peers.

#5 Improved Self-Esteem

A child's self-image dramatically affects their ability to be successful. If they have a poor self-image, they tend to be withdrawn and not take the initiative to try new things. Improving their self-esteem, however, can help them gain the confidence to pursue opportunities and experiences they may not have explored. This is one of the many benefits of prosthetics.

Complications Related to Pediatric Prosthetics

problems with child prosthetics

Major extremity amputations are fraught with potential and overt complications - caused mainly by rehabilitation mismanagement. The good news is you can avoid problems with child prosthetics if you follow your doctor's advice and monitor your child's growth.

Edema

Amputation may cause edema because when a limb is removed, the body's circulatory system is disrupted, resulting in fluid buildup in the area where the amputation occurred. This causes swelling, pain, and other symptoms. In some cases, edema can result from poor circulation due to a condition such as diabetes, or it may be due to nerve damage caused by the amputation.

Infection

Prosthetics for children cause challenges like infection if they are not cleaned and maintained correctly. Bacteria and other microorganisms can collect on the surface of the prosthetic and enter the skin, leading to an infection. Other causes include using inappropriate materials and poor-fitting prosthetics.

Bursitis

Bursitis is an inflammation of a bursa, a small sac filled with fluid that cushions the joints. Prosthetics can cause bursitis if they are too tight, rubbing against the skin and irritating the bursa. If your child's prosthetics are not fitted properly, they will cause increased friction and exert pressure on the bursae, leading to this type of inflation.

Symptomatic Neuromata

Sometimes, when a prosthetic does not fit correctly or is misused, it causes nerve compression, leading to pain, tingling, numbness, or limb weakness. Additionally, if the prosthetic is not adequately maintained or cleaned, it can cause irritation or infection of the skin and underlying tissue, which can also lead to symptomatic neuromata.

Ulceration

Prosthetics can cause ulceration when they are ill-fitting or rub against the skin. Improperly fitted prosthetics lead to excessive pressure on the skin and underlying tissue, producing shearing forces which can damage the skin and cause ulceration.

Myodesis Failure

Prosthetic myodesis failure is caused by various factors, including poor fit, incorrect alignment, inadequate tissue coverage, muscle control, and nerve function. A poor fit can occur when the prosthetic is the wrong size or shape for the individual, when the socket does not fit snugly around the limb, or when the prosthetic does not fit the user's body shape.  

Bone Spurs

Bone spurs can occur when the joint is repeatedly subjected to abnormal amounts of stress or a poorly fitting prosthetic, leading to the formation of new bone. This results in pain, stiffness, and decreased range of motion in the affected joint.

Contact Dermatitis

Child prosthetics can cause contact dermatitis due to prolonged skin contact with the material of the prosthetic. The artificial materials may contain irritants, such as plastics, metals, and rubbers, that cause an allergic reaction.

Replacing Your Child's Prosthesis: How Often Is Necessary?

Replacing prosthetic limbs too often can be detrimental to the child, so it is recommended that a prosthesis be oversized so that the child can adjust and grow into it. Fitting, fabricating, and aligning a new device also takes time. Research suggests that a child with a prosthetic limb will need a new device annually up to the age of 5, every two years from the ages of 5 to 12, and every three years from the ages of 4 to 21.

Parental Considerations Around Prosthetic Use

arm prosthetic for child

Parents of children with limb differences must find a balance between two extremes when determining when their child should use a prosthesis. Some may insist on encouraging prosthesis use, while others grant their child full control. You must consider your child's age, as very young toddlers may be unable to make this choice independently, for example.

It is also important to consider the benefits and pitfalls of prosthesis use. For lower-limb differences, wearing a prosthesis can help infants and young children explore their environment more efficiently by assisting them in achieving a standing position. Crawling is a mixed bag, as it can be beneficial sometimes, and a prosthesis should be taken off if it interferes.

However, a prosthesis is often necessary to transition from crawling to standing, usually between 8 and 14 months. For upper-limb differences, a prosthesis can help the child manipulate objects. Therefore a child with a prosthetic hand should usually be fitted earlier than a child with a prosthetic leg.

However, prosthesis use can also cover up body parts receptive to sensations, and the child may not want to wear it because the skin provides valuable feedback about the environment.

Supporting Children Through Their Prosthetic Journey

Explaining amputation to a child and learning to use prosthetic limbs can take much time and instruction. Naturally, there is a child adjustment period for prosthetics. Primecare's team will work with you and your child to teach them how to put on and take off the prosthetic and take care of it. We will also guide you in recognizing when the prosthetic needs to be adjusted.

Additionally, we strongly recommend families find support groups for parents and children with prosthetic limbs. Connecting with other kids in similar situations can help build your child's confidence and provide a source of peer support. Similarly, being able to talk to other parents can also benefit you.

The Cost of Prosthetics for Children

best age for a prosthetic as a child

Thousands of children are born with limb differences yearly in the US, and many cannot acquire affordable prosthetics. Unfortunately, prosthetic limbs can range in price from $5,000 to more than $50,000, and many insurance companies are unwilling to cover the cost of them. At PrimeCare, we strive to ensure our patients receive the best coverage available.

Supporting Your Child's Limb and Prosthetic Care

Teaching your child how to take care of their prosthetic limb will make them feel like it is part of them and not something they are forced to wear. This will also help them feel they are in control and more independent.

To keep the prosthetic in good condition and avoid any infections, teach your child to do the following:

  • Wash a child's prosthetic hand, foot, or leg regularly and make sure it is completely dry afterward;
  • Check for any signs of redness or infection;
  • Clean any part of the prosthesis that is in contact with their skin;
  • Adjust the prosthesis daily to ensure a proper fit, and always have emergency supplies like extra socks on hand.

Conclusion

At PrimeCare, we provide prosthetic solutions for children with congenital limb deficiencies, traumatic amputations, or amputations due to cancer treatment. Our prosthetics range from traditional to activity-specific ones for playing musical instruments, participating in sports, and more. We've helped many Las Cruces, Albuquerque, and El Paso children find the perfect prosthetic. Contact us for a free consultation.

Request an Evaluation

If you have questions or you are ready to talk about prosthetic options, feel free to schedule a consultation at our clinic.

A grandfather with a prosthesis walks with his grandchildren.