Abstract
Objective
To describe the incidence of overuse musculoskeletal injuries in service members with
combat-related lower limb amputation.
Design
Retrospective cohort study.
Setting
Military treatment facilities.
Participants
Service members with deployment-related lower limb injury (N=791): 496 with a major
lower limb amputation and 295 with a mild lower limb injury.
Interventions
Not applicable.
Main Outcome Measures
The outcomes of interest were clinical diagnosis codes (International Classification of Diseases–9th Revision) associated with musculoskeletal overuse injuries of the lumbar spine, upper limb,
and lower limb regions 1 year before and 1 year after injury.
Results
The overall incidence of developing at least 1 musculoskeletal overuse injury within
the first year after lower limb amputation was between 59% and 68%. Service members
with unilateral lower limb amputation were almost twice as likely to develop an overuse
lower or upper limb injury than those with mild combat-related injury. Additionally,
service members with bilateral lower limb amputation were more than twice as likely
to develop a lumbar spine injury and 4 times more likely to develop an upper limb
overuse injury within the first year after amputation than those with mild combat-related
injury.
Conclusions
Incidence of secondary overuse musculoskeletal injury is elevated in service members
with lower limb amputation and warrants focused research efforts toward developing
preventive interventions.
Keywords
List of abbreviations:
AIS (Abbreviated Injury Scale), ICD-9 (International Classification of Diseases–9th Revision), ISS (Injury Severity Score)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 31, 2017
Footnotes
Supported by the DoD-VA Extremity Trauma and Amputation Center of Excellence (work unit no. N1333).
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
