Buenas noches. Una patología poco frecuente es el defecto por reducción y, de hecho, las directrices y protocolos de manejo de desnutrición aguda, no hacen referencia a la interpretación del peso del niño en ausencia de una extremidad, bien sea por defecto por reducción o amputación, si bien los textos de auxología recomiendan sumar el 5% por cada miembro superior o el 10% en el caso de miembros inferiores.

Me pregunto:

1.- ¿Con qué frecuencia han tratado desnutrición aguda en niños con amputación o defectos por reducción?

2.- ¿Obtienen el peso teórico sumando el 5% o 10%, segun el miembro faltante, al peso real?

3.- ¿Algún protocolo de sus países aborda este tema?

Gracias

DeepL translation:

Good evening. A rare pathology is the reduction defect and, in fact, the guidelines and protocols for the management of acute malnutrition do not refer to the interpretation of the child's weight in the absence of a limb, either due to reduction defect or amputation, although the auxology texts recommend adding 5% for each upper limb or 10% in the case of lower limbs.

I wonder:

1.- How often have you treated acute malnutrition in children with amputation or reduction defects?

Do you obtain the theoretical weight by adding 5% or 10%, depending on the missing limb, to the real weight?

3.- Do any protocols in your countries address this issue?

Thank you. 

An interesting question! I have recently been part of a team reviewing national wasting guidelines with regard to children with disabilities, and we found no specific recommendations for assess anthropometry where standard weight and height are not possible. We have previously consider the issue of children with cerebral palsy who often cannot straighten their legs to stand or lie for length measurements. Measuring knee height and extrapolating to full length has been used in a recent study of children with CP in Ghana: https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.13797 

But the issue you raise is similarly important and one I will mention to co-authors for discussion in our wasting/disability guideline review. 

I am interested to hear about experiences of others too. 

Thanks

NATASHA LELIJVELD
Technical Expert

Answered:

3 years ago
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