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Pediatric Rehabilitation

Session: Factors associated with prosthesis use following pediatric external hemipelvectomy or hip disarticulation

Factors Associated with Prosthesis Use Following Pediatric External Hemipelvectomy or Hip Disarticulation

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Original Research Theater

    Poster Presenter(s)

  • Melanie White, DO (she/her/hers)

    Pediatric Rehabilitation Medicine Fellow
    Mayo Clinic College of Medicine & Science (Rochester) PM&R Program
    Rochester, Minnesota

    • Co-Author(s)

  • JD

    Jennifer Dens Higano, MD

    Physical Medicine and Rehabilitation Physician
    Mayo Clinic College of Medicine & Science (Rochester) PM&R Program
    Rochester, Minnesota

  • JC

    Julia Carter, MD

    Resident Physician
    Mayo Clinic College of Medicine & Science (Rochester) PM&R Program
    Rochester, Minnesota

  • MS

    Matthew Severson, MD

    Pediatric Physiatrist
    Gillette Children’s
    Cottage Grove, Minnesota

  • FS

    Fantley Clay Smither, MD

    Physician
    Mayo Clinic College of Medicine & Science (Rochester) PM&R Program
    Rochester, Minnesota

  • AR

    Amy Rabatin, MD

    Physician
    Mayo Clinic
    Rochester, Minnesota

  • ML

    Mary Lynch, MD

    Assistant professor
    Mayo Clinic
    Rochester, Minnesota

Disclosure(s):
Melanie White, DO: No financial relationships to disclose
Background and/or Objectives: After pelvic level amputation, independent mobility can be achieved with the use of crutches, walker, wheelchair, or prosthesis with or without a gait aid. Our objective is to investigate the incidence of and associated factors with prosthesis use following external hemipelvectomy or hip disarticulation in the pediatric population.

Design: Retrospective chart review

Setting : Tertiary academic medical center

Participants : Twenty-eight individuals who had external hemipelvectomy (n=13) or hip disarticulation (n=15) prior to 21 years of age due to cancer (n=25) or other etiology (n=3) between 1998-2024.

Interventions: Not applicable

Main Outcome Measures: Primary outcome is proportion of patients fitted with prosthesis. Secondary outcomes are factors associated with prosthesis use.

Results: 61.5% (8/13) of individuals with external hemipelvectomy were fit with a prosthesis. 86.7% (13/15) of individuals with hip disarticulation were fit with a prosthesis, including all three who had an amputation not related to cancer. Six individuals who would have been prosthesis candidates though were never fit lived a mean of 111.5 days after surgery. Of those who had PM&R outpatient follow up at our institution (n=18), 94.4% (17/18) were using a prosthesis at last visit but only 16.7% (3/18) were using the prosthesis for primary mobility in the community.

Conclusions: Individuals who were more likely to be fit with a prosthesis included those with a hip disarticulation, those who had amputation unrelated to cancer, and those with longer survival following amputation . While many individuals used their prothesis functionally, it was uncommon to use the prosthesis for primary mobility in the community. This may be because prostheses for pelvic level amputation are complex to fit, can require significant energy to use, and not all individuals are highly motivated to use. A future survey study is planned to understand how individuals decide when to use their prosthesis and which mobility aid to use in their home and in the community.