Bony overgrowth in children after amputation.

This is a seven year old female with history of bilateral congenital lower extremity deficiencies who underwent bilateral below knee amputations with subsequent complaints of progressive pain and difficult fitting of her left prosthesis (Fig. 1). Two years before she had a similar clinical situation that was diagnosed as bone overgrowth. She underwent surgical treatment with simple distal bone resection of her prominent tibia. On examination, the distal end of the left residual limb is painful to palpation. The skin is thin, but there is no evidence of skin breakdown. X-rays shows a tapered distal tibia with a narrow tip, which confirms the diagnosis of recurrent bony overgrowth (Fig. 2). This case raises several questions. 1) How common is bony overgrowth after limb amputation? 2) What patients are more prone to have this complication? 3) Is there an effective treatment for this problem?