Amputation surgery in children is different from that in adults primarily in the sites of amputation. In a child, all length possible should be saved and, wherever possible, amputation levels should be distal to epiphyses rather than proximal. Elective amputation in children to convert anomalous extremities to more satisfactory stumps should be considered individually and should not be done primarily except when the life history of the anomaly is well enough known to indicate that primary conversion is desirable.
Complications of amputation in children are much less severe than in adults. Painful phantoms in my experience do not exist in children. Scars, neuromata, or spurs are not major problems in children and only rarely require revision of the stump. Bone overgrowth is the major complication of amputation in children. It is a manifestation of appositional bone growth and is not related to epiphyseal growth. It is best treated by revision of the stump; it should not be treated by epiphyseodesis and it is not so contra-indication to elective amputation surgery in children.