Abolfazl Rahimi, BSc, MSc; Mehdi Masoumi, MD; Mansoor Soroush, MD; Batool Mousavi, MD, MPH
Abstract
Background: Lower limb amputation is the most common type of amputation in veterans. The aim of the study was to assess the orthopaedic problems in war related bilateral lower limb amputees.Methods: In a cross-sectional study, 335 out of 578 survivors with bilateral lower limb amputation were assessed ...
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Background: Lower limb amputation is the most common type of amputation in veterans. The aim of the study was to assess the orthopaedic problems in war related bilateral lower limb amputees.Methods: In a cross-sectional study, 335 out of 578 survivors with bilateral lower limb amputation were assessed by three orthopaedic surgeons.Results: The mean age was 42.05±6.3 and 97.6% were male. The most common cause of amputation was land mine 89.7% (601 limbs). Both trans-tibia was the most common level of amputation 37.6% (126 people). The length of stump in about half of the survivors was short or tall. The most common orthopaedic problems were spasm of stump muscle 42.7% (281 limbs), which was followed by heterotypic ossification 11.55% (76 limbs), neuroma 10.2% (67 limbs), and inflammation 10.1% (67 limbs). About 10.9% of survivors needed stump revision.Conclusion: The study revealed that the prevalence of orthopaedic complications among the amputees was high. Regular and routine assessment, rehabilitation programs and treatment is necessary for the bilateral lower limb amputees.
Mansour Soroush, MD; Ehsan Modirian, MD; Mahdi Massoumi, MD; Mohammad Reza Soroush, MD
Abstract
Background: Long term follow up of war-related bilateral upper limb amputees is rarely reported. The aim of this study is to evaluate functional problems of residual limbs of these patients.Methods: During a cross sectional study, we gathered 98 patients suffering bilateral upper limb amputation following ...
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Background: Long term follow up of war-related bilateral upper limb amputees is rarely reported. The aim of this study is to evaluate functional problems of residual limbs of these patients.Methods: During a cross sectional study, we gathered 98 patients suffering bilateral upper limb amputation following Iran-Iraq war and an experienced orthopaedic specialist visited all the subjects in regards of stump conditions. The amputees were all men except one and being visited 16.9±5.9 years after injury. The mean age was 37.2±9.7 years (15-82 years).Results: 54.5% of the amputated limbs were at finger or wrist level 34.2% had been performed below elbow and transhumeral or higher amputation was seen in 11.3% of the subjects. 41.8% of the patients had not undergone any more operation after the injury while 24.5% had history of single and 33.2% more than one surgeries after injury (mean: 3.5±4.6 range: 1-33). 40.9% of the stumps didn’t have standard length to wear prosthesis. Too little soft tissue bulk (22%), adhesion of soft tissue to bone and scar (24.2%), and neuroma (37%) were also reported. Evaluations revealed that 35.2% of the stumps needed more surgeries. No statistical correlation between presence of any orthopaedic problem of the stump and use of the prosthesis, level of amputation and number of operation of stumps was found (p < /em>≥0.05).Conclusions: Stump problems along with low rate of limb usage, lack of rehabilitative programs and insufficient training and support for prosthesis usage would result in disuse of assistive devices.
