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The Role of Prosthetic and Orthotic Care Following Cancer Treatment in Children


By Tracy A. Melton, CPO, LPO, C.PED, Comprehensive Prosthetics & Orthotics

Every year about 800 Americans are diagnosed with Osteosarcoma, a rare bone cancer most commonly found in children and teens. Most often these tumors are found in the lower leg, thigh, and upper arm. Chemotherapy is a standard treatment for most individuals to shrink the tumor prior to surgical removal of the cancerous tissue. During the removal process of the tumor, efforts are made to save the affected limb. This process is called limb sparring and is common with these types of surgeries, the goal being to save the remaining tissues of the limb. In some situations, amputation of the limb is performed due to irreparable tissue damage.

For the Carter family, they have experienced cancer with not one but both of their children. Haley and Austin are two young active individuals, who in a short time, went through the process of limb sparring due to an osteosarcoma in their lower extremities. Haley was the first to be diagnosed with an osteosarcoma in her left leg when she was nine years old and within ten months, Austin was also diagnosed with the same cancer, only his was in his right leg.

Both children underwent treatment for the cancer and both went through limb sparring procedures; however, the result was very different for each of them. Haley’s limb sparring procedure was successful and she now has a prosthetic tibia which can be lengthened to accommodate for growth. She has been through many procedures to get to where she is now and has had her tibia extended three times with good success. Austin’s limb sparring procedure did not work in the same way his sister’s did, his limb sparring failed and resulted in an above-knee amputation.

With multiple surgeries and trauma to Haley’s and Austin’s lower extremities, both would need prosthetic and orthotic intervention to allow for better functioning. Haley, with an ankle foot orthosis (AFO) that would provide strength and protection of her prosthetic tibia and Austin, an above-knee (AK) prosthesis to replace what was no longer there. Both Haley and Austin had goals of returning to an active lifestyle as both were very involved in sports and neither wanted their cancer to limit their activities and dictate what they could and could not accomplish.

Since Haley’s limb sparring procedure she presents with limited range of motion and instability at her ankle. She also developed foot drop, a condition where someone has difficulty or inability to raise their foot while walking, making it difficult to ambulate without dragging her toes on her affected foot. Haley has been working with her orthotist, Saravanan Sundarkrishnan, CPO, LPO to help manage the condition of her affected limb. The type of device Haley needs to wear is a custom fabricated ankle foot orthosis (AFO) specifically designed to optimize her gait and provide the best support and function possible. Although Haley will most likely have limitations regarding her range of motion and how active she can be until her prosthetic tibia is permanent, she has not let her condition slow her down. Haley is a goalie for her school lacrosse team and she continues to be as active as possible, just like any kid her age should be.

After Austin’s above-knee amputation he has been working with his prosthetist, Robin McRae, CP, LP to get a custom fit prosthesis to replace his amputated limb. His prosthetist specializes in designing and fabricating a socket that will support Austin and allow for attaching the best prosthetic components available to optimize his function during standing, walking, running, and any other activity he feels he is capable of doing. Austin has been wearing a prosthetic leg for several years now and has been through a number of components and sockets to accommodate his changing limb, growth and activity level. He more recently received a specialized running foot that he uses not only for running, which he did prior to his amputation, but for all types of activities; including those that he once felt limited in doing. With his new foot he is again pushing his limits on what he can do and achieving many goals he has set out for himself. Although both Haley and Austin were both affected with the same cancer, their outcomes were very different. Neither of the Carter kids let cancer slow them down and both are determined to live life to the fullest and continue to move forward.

CPO provides orthotic and prosthetic care to patients throughout Central Illinois. The Bloomington office is located at 902 N. Hershey Road; call 309-664-6930 to schedule an appointment. CPO also houses an on-site fabrication department where custom orthoses and prostheses are designed and created for each patient. Visit the website at

Photo courtesy Comprehensive Prosthetics & Orthotics