For decades, prosthetic care has primarily focused on adults, creating significant gaps in paediatric services. Adult prosthetics are designed for stable body dimensions, whereas children’s bodies are constantly growing and changing. This means children typically need multiple prosthetic adjustments and replacements throughout their development, leading to substantial ongoing social and economic costs (see www.lsngroup.org/post/early-intervention-in-prosthetic-care-the-game-changing-potential-to-unlock-higher-roi) for families and healthcare systems.

Moreover, children’s prosthetic needs differ fundamentally from adults’. Whilst adult prosthetics typically optimise for work and daily living activities, children require designs that support play, school participation, and sports. Their prosthetics must be more durable to withstand active play and have different weight-to-strength ratios to accommodate their smaller frames.

In response to the crisis in Gaza, LSN is exploring ways of establishing a comprehensive paediatric amputee care programme that addresses these longstanding challenges through the Restoring Hope Initiative.

The approach combines several innovative elements that could serve as a model for paediatric amputee care worldwide.

The first element is the introduction of fast-fitting prosthetics, where children can be fitted with prostheses in a matter of a couple of hours, meaning that they don’t lose weeks with fittings and avoid all the commensurate complications ( physical, emotional, educational, psychological) that a delay invokes.

For upper limbs at least, fast-fitting prosthetics can be fitted within 24 hours of surgery, so the prosthesis, like getting a new pair of glasses or new shoes, immediately becomes part of their identity.

The second element is the use of modular prosthetic systems specifically designed for children, building on existing, proven technologies. The new features involve adjustable components that can “grow” with the child, significantly reducing the need for frequent replacements. The designs prioritise affordability and durability whilst maintaining functionality, making them particularly suitable for resource-limited settings. Modular prosthetics also reduce economic (and social) costs hugely (see https://www.lsngroup.org/post/transforming-lives-through-sustainable-prosthetics, as individual components can be replaced rapidly and cheaply with a child’s growth.

Perhaps most significantly, this new programme recognises that successful paediatric amputee care extends far beyond the prosthetic device itself. Their integrated support system needs to combine physical therapy, psychological support, and educational assistance. We have documented in other briefs peer support networks that connect families facing similar challenges, whilst vocational training programmes help older children plan for their futures.

The programme can place greater emphasis family involvement, acknowledging that children’s care requires active participation from carers. Whilst in healthcare the focus is on the patient, with children the care they receive may affect the entire family. Caring for children is also about ensuring the family receive comprehensive education about prosthetic care, rehabilitation exercises, and supporting their child’s psychological adjustment.