Citation

Krueger CA, Wenke JC, Cho MS, Hsu JR. J. Orthop. Trauma 2014; 28(4): 227-231.

Affiliation

1Brooke Army Medical Center, Ft. Sam Houston, TX 2United States Army Institute of Surgical Research, Ft. Sam Houston, TX.

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/BOT.0b013e3182a665f5

PMID

23912860

Abstract

OBJECTIVES:: Much attention has been given to lower extremity amputations that occur more than 90 days after injury but little focus has been given to analogous upper extremity amputations. The purpose of this study was to determine the reason(s) for desired amputation and the common complications after amputation for those combat-wounded Servicemembers who underwent late upper extremity amputation. DESIGN:: Retrospective case series SETTING:: Tertiary trauma center PATIENTS/PARTICIPANTS:: All U.S. Servicemembers who sustained major extremity amputations from September 2001- July 2011 were analyzed. INTERVENTION:: Late (90+ days after injury), upper extremity amputations. MAIN OUTCOME MEASUREMENTS:: Amputation level(s), time to amputation, age, number of operations, pre/post-operative complications, reason(s) for desiring amputation and disability outcomes were analyzed. RESULTS:: 7 of 218 (3.2%) upper extremity amputees had a late upper extremity amputation (>90 days from injury to amputation). The mean and median number of days from injury to amputation was 689 and 678, respectively. The most common pre-amputation complications were loss of wrist or finger motion (7, 100%), neurogenic pain (4, 57%) and heterotopic ossification (4, 57%). Three (43%) patients (two persistent, one new onset) had neurogenic pain and 2 (29%) had heterotopic ossification after amputation. Only 57% (4 out of 7) of amputees used their prostheses regularly. CONCLUSION:: Servicemembers undergoing late upper extremity amputation appear to have different pre and post-operative complications than those patients undergoing late lower extremity amputations. It was common for the amputee to not wear their prostheses and to experience similar complications after amputation, albeit in a less severe form.

Language: en