Limb Deficiencies (reduction defects)
A reduction deformity is the congenital absence or shortening of a limb or part of a limb. This is sometimes caused by prenatal exposure to certain drugs, such as thalidomide, though often the cause is unknown. It is sometimes detected before birth on prenatal ultrasound. Although there are many causes of limb reduction, women who take folic acid during pregnancy have a 30-40% reduced risk of having a child with a limb deformity. Lower limbs are affected less often than upper limbs. Treatment for limb reduction will be unique to each child since no two children will have the same issues. Surgery may be needed, to obtain stability of the lower limb for proper weight-bearing and to create a good fit for a prosthesis. Since many children have other problems besides the limb reduction, the treatment plans may be relatively straight-forward, or may involve multiple subspecialists also treating the associated conditions. The Shriner's Hospitals nationwide are very focused on assisting children and families with limb reduction conditions and can be an excellent source of resources and support. As children grow, they will need to be evaluated regularly to be sure they are receiving the best possible assistance through surgery, prosthetics, or other adaptive equipment, to live a full and active life. Further surgeries, on their affected limb may be necessary, or perhaps they will be fitted with an advanced prosthesis that will give them new options for their activities. Limb reduction occurs in approximately 14 of 100,000 live births.
Using data from Minnesota births between 2014-2018, we found 120 babies were born with limb deficiencies, resulting in a rate of almost 4 babies per 10,000 births. Annually, about 24 babies were born with limb deficiencies.
Parental education and support are essential, and local, regional, and national organizations may be very helpful.