Limb Deficiency Clinic
Devoted Exclusively to Limb Deficiency and Deformity Care
Limb Deficiency Clinic
At the Limb Deficiency Clinic at Nationwide Children’s Hospital, patients have access to the broad resources and expertise of our entire hospital, while also having the attention of a subspecialist in physical medicine and rehabilitation and a community prosthetist and orthotist who specialize in pediatric limb deficiency care.
Instead of following patients as part of a larger practice with few cases of limb deficiencies, our clinic focuses exclusively on young patients with congenital and acquired limb differences, from birth defects to amputations due to tumors, infection or trauma.
Young people with limb deficiencies grow and start new activities just like other children. As they do, their equipment and adaptive strategies need to change along with them. The Limb Deficiency Clinic at Nationwide Children’s offers a care team that can follow patients for the long term get to know each child’s individual needs.
Revolutions in limb care and adaptive technologies are frequent. By staying involved with annual or biannual check-ups at a specialized clinic, you can be sure your family will be informed when a new therapy or adaptive tool that may work for your child becomes available.
From children born with missing or deformed limbs to patients with acquired limb deficiencies, our experts offer treatment for all limb-related needs, including:
- Prosthetic and orthotic evaluation and prescriptions
- Prosthetic and orthotic fit assessment and potential adjustment
- Injury and use assessments and treatment
- Physical and occupational therapy
- Psychological support
- Long-term follow-up assessments of growth and function
Young people with limb deformities and deficiencies often require frequent adjustments in equipment, adaptive strategies, and physical and occupational therapy techniques. As they grow and use their affected limbs for new activities, patients will need periodic adjustments and even new orthotic or prosthetic devices.
The Limb Deficiency Clinic offers a care team that can follow patients for the long term, get to know each child’s individual needs, address family questions and concerns and make recommendations based on longer visits — at least 30 minutes — with the doctor.
You can expect:
- Time with an athletic trainer at the start of your visit to cover introductory questions and review some basic exercises targeted for your limb needs
- An in-depth evaluation with Clinic Director Jonathan Napolitano, MD, including discussion about the impact of limb loss, short- and long-term expectations, physical therapy and other treatment options, and an overall management plan
- An extensive consultation with the clinic’s community prosthetist and orthotist, who will collaborate on your child’s prosthetic or orthotic device needs. If you already have an established provider, we will communicate and consult with that professional on your child’s behalf.
- Guidance for your long-term follow-up, information for any needed referrals, and instructions for at-home exercises and limb care
Young people with limb deficiencies grow and start new activities, and their equipment and adaptive strategies need to change along with them. The Limb Deficiency Clinic offers a care team that can follow patients for the long term and get to know each child’s individual needs.
Meet the Director
Dr. Napolitano specializes in musculoskeletal health, amputee gait biomechanics, and the common growth- and use-related prosthetic and orthotic concerns facing children with physical disabilities. He is board certified in physical medicine and rehabilitation and gained some of his extensive experience with physical disabilities and their long-term management at the Hines Veterans Affairs Hospital, treating soldiers returning from war with limb loss.
Research interests include quality of life among children with physical deformities, gait and motion analysis, and the use of emerging technologies in evaluation and treatment of limb deficiencies and deformities.
Prosthetics and Orthotics Experts
To ensure that our patients have access to the best resources for prosthetic and orthotic fittings and adjustments, we work with skilled professionals in the community. These prosthetists and orthotists have expertise in working with young and growing patients and their families.
If you are interested in prosthetic or orthotic evaluations or care, you can expect:
- An in-depth consultation with a board-certified and licensed expert from the community
- Proper evaluation for devices to simplify the prescription process
- Personalized fitting assessments and adjustments, as well as follow-up assistance with devices as needed
- Education on a wide range of device options based on your needs and preferences
- Periodic reassessments to ensure the device continues to offer proper function and fit
The Power of a Specialized Multidisciplinary Team
In addition to Dr. Napolitano and a professional prosthetist and orthotist who specializes in pediatric care, patients have access to the program’s broad clinical team, which includes experts in pediatric limb deficiencies and deformities from the following disciplines:
- Physical and occupational therapy
- Physical medicine and rehabilitation
- Sports medicine
- Orthopedic surgery
Together with the patient and family, the team creates a care plan to enable children and adolescents to achieve their ultimate potential function and comfort.
We provide a full-spectrum of long-term limb deficiency care. Our program offers referrals to a wide array of highly specialized community and hospital resources.
Patients of the Limb Deficiency Clinic have access to many hospital services and community resources for young people with limb deficiencies and deformities, including:
- The Adaptive Sports Medicine Clinic, which offers full-spectrum athletic training and injury care for young people with limb deficiencies and deformities
- The Honda Gait Analysis and Mobility Enhancement (GAME) Center, which offers advanced video recording techniques and 3D motion analysis cameras, force platforms and electromyography to evaluate patient movement, abilities and limitations. The center also provides opportunities for research within pediatric orthopedic medicine, injury prevention and rehabilitation
- Orthopedic Oncology
- Plastic and Reconstructive Surgery
- Sports Medicine
- Community orthotics and prosthetics experts
- Community adaptive activity programs and support organizations
Our clinic’s care team conducts forward-thinking research in children and adolescents with limb deformities and deficiencies. In addition, we collaborate with experts in many related care disciplines at Nationwide Children’s and beyond to help craft the future of limb care.
Research interests and current projects or collaborations include studying quality of life among young people with congenital and acquired limb deficiencies, examining the use of prosthetics in young people and evaluation of targeted muscle reinnervation for pain control and functional enhancement.