About the Limb Preservation and Reconstruction Program
The care of children with limb differences and limb deformities or limb defects is complex. As a child grows, limb problems can worsen – accentuating the difference in length, or an abnormal bend or rotation of the arm or leg.
The members of the Limb Preservation and Reconstruction Program team at Children’s Hospital of Philadelphia (CHOP) understand these complexities. Whether your child was born with a limb disorder or acquired it due to disease, infection or accident, we are here to provide expert assessment of congenital limb defects and other acquired problems affecting the arm, hand, hip, leg or foot. Our experience helps us to predict changes as your child grows and guides the variety of treatment options we offer.
Our team believes strongly that there is a solution to improve functionality for every child with a limb difference. We are often consulted for treatment and second opinions when a child has a congenital limb deformity, a traumatic injury that impacts a limb or growth plate, or a tumor that affects the length or strength of a limb.
Whatever the nature of your child’s limb difference or deformity, there is an expert at Children’s Hospital with experience treating their specific problem.
How we can help
We work with families and pediatric orthopaedic specialists from all over the world to provide second opinions and consultations so you can make informed decisions about your child’s care. CHOP employs a dedicated orthopaedic referral nurse navigator who can help your family access our world-renowned pediatric limb preservation and reconstruction experts. To connect with our nurse navigator, please complete this form.
Patients in our Limb Preservation and Reconstruction Program have access to a highly skilled and coordinated team of orthopaedic surgeons, hand surgeons, plastic surgeons, microsurgeons and general surgeons with decades of experience treating children with limb deformities and limb differences.
We offer treatment options ranging from education and rehabilitation, to cutting-edge surgical intervention and custom prosthetics. No matter which option you choose for your child, our pediatric patients have some of the best outcomes in the nation.
We are happy to arrange for your child or family to meet with other patients already under our care so you can better understand the treatment or treatments proposed for your child and reduce any concerns you may have.
We are here to help – at CHOP’s Philadelphia Campus, or at one of our CHOP Care Network locations throughout Pennsylvania and New Jersey – to provide comprehensive care and support for your child and your family.
A comprehensive team and access to every pediatric subspecialty
No matter what type of limb deformity or difference your child has, there is an expert at Children’s Hospital of Philadelphia with experience in the treatment of their specific issue.
Surgeons from the Limb Preservation and Reconstruction Program work closely with physicians from rehabilitative medicine, genetics, radiology, interventional radiology, oncology (including orthopaedic oncologists), hematology and pathology. In addition, skilled nurses, orthotists, prosthetists, physical and occupational therapists, bone health specialists and social workers are available on site to provide comprehensive support for your child and your family.
We work together with other programs at CHOP Orthopaedics that focus on specific needs your child may have that may benefit from additional layers of sub-specialized care, including:
- Bone and Soft Tissue Tumor Program
- Cerebral Palsy Program
- Foot and Ankle Program
- Hand and Arm Disorders Program
- Hip Disorders Program
- Orthopaedic Trauma Program
- Sports Medicine and Performance Center
We will help your family navigate every step of the way and create the best possible care team for your child’s unique needs.
Our program uses the most cutting-edge imaging, testing and diagnostic tools available to plan for your child’s care.
Among these techniques, we use the EOS Imaging System (a low-dose, 3-D imaging system) to scan your child’s natural, weight-bearing posture, allowing us to see the interaction between the joints and the rest of the musculoskeletal system, particularly the spine, hips and legs. This is an invaluable tool in diagnosis and helps us personalize your child’s treatment.
Computed tomography, commonly called a CT scan, and magnetic resonance imaging (MRI) also provide valuable information about your child’s bones, joints, organs and other structures – and the interplay between them. These images allow us to see areas of your child’s anatomy that previously were only visible through surgery.
Together, these images can then be used to create 3-D digital models of your child’s bones. These 3-D printed models help our surgeons visualize your child’s limb difference from every angle and assists in planning which specific surgical approach will be most effective for your child’s individual condition.
Treatment goals and procedures offered
The goals of treatment are to correct limb differences by:
- Maximizing the affected limb’s strength, range of motion and function
- Creating straight limbs that are sized appropriately for your child and will grow with them
- Lengthening or shortening a limb (guiding the growth or slowing it down) to make the limbs (e.g., both legs or both arms) more equal in size; thus, increasing your child’s functional abilities and giving them a more typical appearance
We offer a broad range of treatments for limb differences and deformities including:
- Limb realignment (straightening), lengthening, growth modulation or shortening.
- Epiphysiodesis, to slow the grown of the longer limb – either temporarily, though a reversible procedure, or permanently.
- Limb preservation (limb salvage) to save a limb after tumor or serious injury.
- Vascularized bone grafts for surgical limb reconstruction of bone defects due to tumors, trauma or infection. We’re one of the few programs in the country to offer this type of specialized, microvascular surgery for pediatric patients.
- Fitting for orthotics and/or prosthetics, such as bracing and shoe lifts.
- Physical and occupational therapy, as well as exercise programs tailored to each patient’s specific needs.
- Psychosocial support and additional support for continued participation in school, sports and peer activities.
Breakthroughs in research
Treating pediatric limb deformities and differences requires analyzing many complex and interrelated factors such as the patients’ age and stage of growth; the shapes, alignment and motion of the child’s entire musculoskeletal system (spine, hips, upper and lower limbs); as well as how the limb difference is impacting the child’s ability to perform activities of daily living.
Our team of surgeons and researchers have found new treatments for limb lengthening that – for many patients – avoids the need for external fixation and pins through the skin and bone to correct the deformity – once the gold standard of care for limb differences. One newer treatment is the use of electromagnetic rods and plates to lengthen long bones without the need for external devices. Learn more.
Our researchers are also using advanced imaging and motion analysis to collect data on a range of conditions and patient populations. These tools help doctors visualize the musculoskeletal problem and determine the best treatment options for their patients. Learn more about orthopaedic engineering and 3D musculoskeletal imaging research at CHOP.