Long-term clinical outcomes of war-related hip disarticulation and transpelvic amputation

J Bone Joint Surg Am. 2013 Aug 21;95(16):e114(1-6). doi: 10.2106/JBJS.L.01160.

Abstract

Background: The Iran-Iraq war (1980 to 1988) was one of the longest wars of the twentieth century. Few studies are available in the current literature evaluating the long-term results of proximal lower-extremity war-related amputations. The purpose of the present cross-sectional study was to evaluate the current health-related quality of life and clinical musculoskeletal function of Iranian veterans with hip or hemipelvic amputation.

Methods: Seventy-six patients from a cohort of eighty-four veterans with hip disarticulation and transpelvic amputation participated in this study. A Persian version of Medical Outcomes Study Short Form-36 (SF-36) was completed for all of the veterans.

Results: The average duration of follow-up was 26.6 ± 3.7 years. The average age (and standard deviation) of the veterans was 44.1 ± 7.0 years. The average scores for the physical and mental health dimensions of the SF-36 were 45.85 ± 21.56 and 57.98 ± 25.19, respectively. These data indicate that the amputees were doing better in the mental domain than in the physical domain. Forty-five patients with a primary amputation (97.8%) and ten with a secondary amputation (33.3%) complained of pain in the amputation stump.

Conclusions: Veterans with proximal lower-extremity amputation will need life-long care. Supervision starts with stump management and the application of appropriate surgical techniques at the time of the injury and continues with periodic examination throughout life.

MeSH terms

  • Adult
  • Aged
  • Amputation Stumps / surgery
  • Amputation, Surgical / methods*
  • Amputees / psychology*
  • Cross-Sectional Studies
  • Disarticulation / methods*
  • Hip / surgery*
  • Humans
  • Iran
  • Iraq
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pelvis / surgery*
  • Phantom Limb / surgery
  • Treatment Outcome
  • Veterans / psychology*
  • Warfare