What is the emotional acceptance after limb salvage with an expandable prosthesis?

BACKGROUND: Limb preservation surgery for extremity sarcomas offers the promise of improved function and cosmesis over amputation. Application of limb salvage surgery for pediatric patients with expandable metallic endoprostheses is gaining acceptance. The few studies reporting these devices have focused on functional outcomes; one has addressed quality of life.

QUESTIONS/PURPOSES: We asked the following questions: (1) how happy are these patients; (2) how do these patients perceive their bodies; (3) do these children have difficulty with social interactions; and (4) how satisfied are patients and their parents with their outcomes?

METHODS: We retrospectively identified and contacted 26 living patients who underwent limb salvage with an expandable device. The Pediatric Outcomes Data Collection Instrument was administered to 15 of the 26 families. Attention was paid to the happiness domain of the Pediatric Outcomes Data Collection Instrument and specific answers within this domain were reported.

RESULTS: Children who received limb salvage with an expandable endoprosthesis showed high emotional satisfaction with their outcome. Overall patients reported excellent perceptions of body image and physical attractiveness. Most patients reported frequent social interactions with their peers and no difficulty with making new friends.

CONCLUSIONS: Although this study has a limited number of subjects and no control group, the data correlate with previously scores and indicate a high degree of emotional acceptance after limb salvage with an expandable endoprosthesis in a pediatric population.