According to a retrospective analysis published August 15 in The Journal of Bone and Joint Surgery, revision amputation to address surgical complications and persistently symptomatic residual limbs improved the patient’s overall acceptance of the prosthesis and led to outcomes equivalent to those following amputations that did not require revision.
A team of physicians from Orthopaedic Surgery Service, Walter Reed National Military Medical Center, Bethesda, Maryland, performed a retrospective analysis of a consecutive series of 96 personnel who had sustained a total of 100 major combat-related upper-limb amputations in Operation Iraqi Freedom and Operation Enduring Freedom. Pre-revision and post-revision outcome measures, including prosthesis use and type, the presence of phantom and residual limb pain, pain medication use, and return to active military duty, were identified for all patients, according the abstract.
All amputations resulted from high-energy trauma, with 87 percent occurring secondary to a blast injury. Forty-two residual limbs underwent a total of 103 repeat surgical interventions. The physicians indicated that as compared with patients with all other amputation levels, those with a transradial amputation were 4.7 times more likely to have phantom limb pain and 2.8 times more likely to require neuropathic pain medications. In the group of patients who underwent revision surgery, regular prosthesis use increased from 19 percent before the revision to 87 percent after the revision.
Editor’s note: This story is adapted from materials provided by The Journal of Bone and Joint Surgery.
