title: Managing the upper extremity amputee: a protocol for success.
abstract: Since the beginning of Operation Enduring Freedom and Operation Iraqi Freedom, over 541 clients with major limb amputations have been seen in the Military Healthcare System. As a result of the nature and severity of injuries and the prevalence of concomitant injuries seen in this population, amputee care has become a specialized type of rehabilitative care at Walter Reed and Brooke Army Medical Centers. To streamline and accommodate the needs of clients with upper extremity limb loss, a five-phased upper extremity amputee protocol of care was developed. The five phases of the protocol include acute management; preprosthetic training; basic prosthetic training; advanced prosthetic training; and discharge planning. For the readers ease, these phases will be presented in the following categories: acute care, subacute care, and long-term rehabilitation needs. Furthermore, this article seeks to offer insight into the ideal treatment of an individual with upper extremity limb loss based on experience and collective expertise of the authoring therapists.
authors.affiliation: United States Army Health Clinic - Schofield Barracks, Schofield Barracks, Hawaii 96789, USA. lisa.smurr@us.army.mil
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Smurr
authors.forename: Kristin
authors.initials: K
authors.lastname: Gulick
authors.forename: Kathleen
authors.initials: K
authors.lastname: Yancosek
authors.forename: Oren
authors.initials: O
authors.lastname: Ganz
mesh_terms: D000203:Activities of Daily Living; D000671:Amputation, Surgical; D000674:Amputees / Q000523:psychology; D001186:Artificial Limbs; D002985:Clinical Protocols; D007839:Functional Laterality; D006801:Humans; D008889:Military Personnel; D009788:Occupational Therapy; D010351:Patient Discharge; D010591:Phantom Limb / Q000534:rehabilitation; D026741:Physical Therapy Modalities; D011474:Prosthesis Design; D012944:Social Support; D014481:United States; D034941:Upper Extremity / Q000293:injuries* / Q000294:innervation; D014945:Wound Healing