title: Unilateral lower-limb loss: prosthetic device use and functional outcomes in servicemembers from Vietnam war and OIF/OEF conflicts.
abstract: Rehabilitation goals following major combat-associated limb loss in World War II and the Vietnam war focused on treatment of the injury and a return to civilian life. The goal for Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) servicemembers is to restore function to the greatest possible degree and, if they desire, return them to Active Duty, by providing them with extensive rehabilitation services and a variety of prosthetic devices. Our study determines the usefulness of these diverse types of prosthetic devices for restoring functional capability and documents prosthesis use and satisfaction. We compare servicemembers and veterans with major combat-associated unilateral lower-limb loss: 178 from the Vietnam war and 172 from OIF/OEF conflicts. Of survey participants with unilateral lower-limb loss, 84% of the Vietnam group and 94% of the OIF/OEF group currently use at least one prosthetic device. Reasons for rejection varied by type of device, but common reasons were pain, prosthesis too heavy, and poor fit. Abandonment is infrequent (11% Vietnam group, 4% OIF/OEF group). Future efforts should aim to improve prosthetic-device design, decrease pain, and improve quality of life for these veterans and servicemembers.
authors.affiliation: Department of Veterans Affairs (VA) Miami Healthcare System, Miami, FL, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gailey
authors.forename: Lynne V
authors.initials: LV
authors.lastname: McFarland
authors.forename: Rory A
authors.initials: RA
authors.lastname: Cooper
authors.forename: Joseph
authors.initials: J
authors.lastname: Czerniecki
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Gambel
authors.forename: Sharon
authors.initials: S
authors.lastname: Hubbard
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Smith
authors.forename: Michele
authors.initials: M
authors.lastname: Raya
authors.forename: Gayle E
authors.initials: GE
authors.lastname: Reiber
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D055826:Afghan Campaign 2001-; D000673:Amputation, Traumatic / Q000534:rehabilitation*; D005260:Female; D006306:Health Surveys; D006801:Humans; D054542:Iraq War, 2003-2011; D035002:Lower Extremity / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D019736:Prostheses and Implants / Q000706:statistics & numerical data*; D011788:Quality of Life; D012656:Self-Help Devices / Q000706:statistics & numerical data; D014728:Veterans; D047829:Vietnam Conflict; D055815:Young Adult