title: The Northern Ireland troubles and limb loss: a retrospective study.
abstract: The Troubles in Northern Ireland have now lasted 34 years. Divisions and strife between the opposing loyalist and republican communities, and between the communities and the security forces, have led to thousands of deaths and injuries. The violence has often been indiscriminate injuring and killing totally innocent people. Staff at the Regional Disablement Services at Musgrave Park Hospital, Belfast have had the responsibility for helping to rehabilitate those who have suffered limb loss, both civilians and security forces personnel. In this study the authors present patient demographics for those survivors, referred for prosthetic fitting, who have sustained limb amputations as a result of the Troubles from 1969 to 2003, with the cause of injury, resulting levels of amputation, associated injuries, time to first prosthetic fitting and reason for any delay in fitting identified. One hundred and twenty-nine (129) patients sustained amputations, 110 male and 19 female with an age range at the time of injury from 7 to 60 years. Seventy-two (72) were civilian. Ninety-three (93) underwent immediate amputation, the most frequent level of amputation being trans-femoral. Delayed healing of deep wounds was the most common reason for delayed amputation; other causes were chronic osteomyelitis, malunited fractures and failed arthrodesis, often associated with chronic pain. Ninety-two (92) patients required amputation of one limb or part thereof, 35 required amputation of 2 limbs and 2 underwent triple amputation. Three (3) patients lost both hands. Sixty seven percent (67%) had other associated physical injuries. Thirty-two (32) patients had a delay of 6 months or more in fitting a prosthesis. The most common cause of injury was the car bomb.
authors.affiliation: Regional Disablement Service, Musgrave Park Hospital, Belfast, Northern Ireland. lorradam@yahoo.com
authors.forename: L E
authors.initials: LE
authors.lastname: Graham
authors.forename: R C
authors.initials: RC
authors.lastname: Parke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000534:rehabilitation / Q000706:statistics & numerical data*; D001174:Arthrodesis / Q000009:adverse effects; D001186:Artificial Limbs; D002648:Child; D005107:Explosions; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009660:Northern Ireland / Q000453:epidemiology; D010019:Osteomyelitis / Q000503:physiopathology / Q000601:surgery; D010146:Pain / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D034941:Upper Extremity / Q000601:surgery; D014857:Warfare; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*