Late surgical management of residual limb and ischemic contracture complications in pediatric earthquake survivors

Purpose: This study aimed to evaluate late extremity complications and the surgical management strategies used in pediatric patients who developed residual limb problems or ischemic contractures following the February 6, 2023 Kahramanmaraş earthquake.Materials and Methods: This retrospective observational study included pediatric patients who underwent surgical treatment for amputation stump complications or ischemic contractures secondary to compartment syndrome. Demographic characteristics, complication types, surgical procedures, number of operations, and infection rates were analyzed. Results: A total of 18 pediatric patients were included, with a mean age of 14.28±5.42 years. The most common late complications were soft tissue insufficiency (33.3%), pressure ulcers (27.8%), and osseous overgrowth (22.2%). Patients with stump-related complications were significantly younger than those with ischemic contractures (12.25±5.34 vs. 18.33±2.73 years). Stump complications were primarily managed with revision procedures, whereas ischemic contractures more frequently required reconstructive procedures, including tendon release, tendon transfer, and metatarsal extension osteotomies. Conclusion: Late extremity complications in pediatric earthquake survivors show distinct clinical patterns depending on the initial injury and treatment strategy. Amputation stump complications often require revision surgery, whereas ischemic contractures are more commonly managed with reconstructive procedures aimed at restoring functional alignment and improving weight distribution.