Highlights
- •Development of overuse musculoskeletal conditions could have a significant influence on quality of life for Service members with traumatic upper limb amputation.
- •Incidence of overuse musculoskeletal injuries within one year after injury is high in-Service members who have sustained combat-related upper limb amputation.
- •Research efforts for devising rehabilitation programs geared toward prevention and mitigation of secondary overuse musculoskeletal injuries after upper limb loss is warranted.
Abstract
Study design
Retrospective cohort study
Introduction
Service members who have sustained traumatic amputations are typically young and otherwise
healthy. Beyond standard care, these individuals desire long, highly active, and relatively
pain-free lifestyle, whether that is returning to active duty or transitioning to
civilian life. Development of overuse musculoskeletal conditions could have a significant
influence on quality of life for Service members with traumatic upper limb amputation.
Purpose of the study
Compare one-year incidence of overuse musculoskeletal injuries in Service members
with different levels of combat-related upper limb amputation to Service members with
minor combat-related upper limb injuries.
Methods
Service members with deployment-related upper limb injury (N = 519), 148 major upper
limb amputation (55 with amputation at or above elbow, 93 with amputation below elbow)
and 371 minor upper limb injury were included in the study. Outcomes of interest clinical
diagnosis codes associated with overuse conditions of the upper limb, neck and upper
back, lower limb, low back pain, and all regions combined, one year before and one
year after injury.
Results
Overall, the one-year incidence of developing at least one musculoskeletal overuse
condition after upper limb amputation was between 60% and 65%. Service members with
upper limb amputations were 2.7 to 4.7 times more likely to develop an overuse upper
limb condition, 3.6 to 3.8 times more likely to develop a neck and upper back condition,
2.8 to 4.4 times more likely to develop a lower limb condition, and 3.3 to 3.9 times
more likely to develop low back pain as compared those who sustained minor combat-related
injuries. No significant differences in the odds of developing a musculoskeletal condition
was found between the above elbow and below elbow amputation groups.
Conclusions
Incidence of secondary overuse conditions is elevated in Service members with upper
limb amputation and warrants focused research efforts toward preventative and rehabilitative
interventions.
Keywords
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JHT Read for Credit
Quiz: # 929
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The study design is
- a.RCTs
- b.prospective
- c.qualitative
- d.retrospective
- a.
- # 2.The two groups were service members with
- a.lower extremity amputation vs those with upper extremity amputation
- b.bilateral amputation vs. unilateral amputation
- c.musculoskeletal complaints but without amputation vs. those with amputation
- d.amputation vs. those with no musculoskeletal complaints
- a.
- # 3.The one-year incidence of developing a musculoskeletal overuse condition was approximately _______
- a.60-65%
- b.50-55%
- c.70-75%
- d.20-25%
- a.
- # 4.Regarding onset of an overuse condition it was found that
- a.there was a shorter time for the non-amputee group
- b.there was a shorter time for the amputee group
- c.there was no significant time difference between groups
- d.no possible explanation was suggested
- a.
- # 5.Amputees were more than twice as likely to develop overuse conditions than the non-amputees
- a.false
- b.true
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: May 16, 2021
Accepted:
May 6,
2021
Received in revised form:
February 1,
2021
Received:
February 17,
2020
Footnotes
Funding: Supported by the Extremity Trauma and Amputation Center of Excellence
Identification
Copyright
Published by Elsevier Inc.
