title: [Subjective impairment after macroamputation of the upper extremity].
abstract: BACKGROUND
  The subjective outcome following macroamputation of the upper limb was evaluated using the DASH score.
  
  
  METHODS
  In a retrospective study, 11 patients with stumps of the upper limb following trauma were investigated 5.6 years after injury. Data according to injury pattern, age, gender, level of amputation and DASH score were collected.
  
  
  RESULTS
  Included are 2 unilateral and 3 bilateral forearm amputees and 6 patients with upper arm amputation. Only males were seen with a mean age of 32 years. Amputation occurred following polytrauma in 3 cases while in the other 8 cases the amputated limb was unreconstructably mangled. 8 patients wear a prosthesis. 4 (36 %) patients are unemployed. The mean DASH score was 44.8, in bilateral forearm amputees 74.16, in unilateral upper-arm amputees 38.47 and in unilateral lower forearm amputees 43.33. Patients with bilateral amputation showed the greatest functional and social impairment. Mean pain was 40 % of the pain section in the DASH questionnaire and showed no difference with regard to the level of amputation or bilateral injury. All patients are socially integrated. Patients with unilateral amputation rated psychological impairment higher than functional impairment.
  
  
  CONCLUSIONS
  Patients with macroamputation of the upper extremity show high psychological and functional impairment. Pain, deficits in function and still not optimal prosthetic devices result in a high percentage of unemployment.
authors.affiliation: Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Medizinische Universität Innsbruck, Anichstrasse 35, Innsbruck, Austria. markus.gabl@uki.at
authors.forename: M
authors.initials: M
authors.lastname: Gabl
authors.forename: A
authors.initials: A
authors.lastname: Kröpfl
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D000672:Amputation Stumps; D000674:Amputees / Q000523:psychology / Q000534:rehabilitation; D001132:Arm / Q000601:surgery*; D001186:Artificial Limbs; D004185:Disability Evaluation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014478:Unemployment