title: Unilateral upper-limb loss: satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts.
abstract: Prosthetic use and satisfaction in wounded servicemembers and veterans with unilateral upper-limb loss has not been thoroughly explored. Through a national survey, we enrolled 47 participants from the Vietnam conflict and 50 from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) with combat-associated major unilateral upper-limb loss. Upper-limb prosthetic devices were used by 70% of the Vietnam group and 76% of the OIF/OEF group. Mechanical/body-powered upper-limb devices were favored by the Vietnam group, while a combination of myoelectric/hybrid and mechanical/body-powered devices were favored by the OIF/OEF group. Upper-limb devices were completely abandoned in 30% of the Vietnam and 22% of the OIF/OEF groups. Abandonment was more frequent for transhumeral and more proximal levels (42% of Vietnam and 40% of OIF/OEF) than more distal limb-loss levels. Upper-limb prostheses were rejected because of dissatisfaction with the device by significantly fewer (23%) members of the Vietnam group than the OIF/OEF group (45%) (p < 0.001). Most common reasons for rejection included pain, poor comfort, and lack of functionality. A significant paradigm shift has been noted in the OIF/OEF group, who use a greater number and diversity of upper-limb prostheses than the Vietnam group.
authors.affiliation: Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA 98101, USA. Lynne.McFarland@va.gov
authors.forename: Lynne V
authors.initials: LV
authors.lastname: McFarland
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Hubbard Winkler
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: Melissa
authors.initials: M
authors.lastname: Jones
authors.forename: Alberto
authors.initials: A
authors.lastname: Esquenazi
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; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D017060:Patient Satisfaction; D019736:Prostheses and Implants / Q000706:statistics & numerical data*; D012656:Self-Help Devices / Q000706:statistics & numerical data; D034941:Upper Extremity / Q000293:injuries*; D014728:Veterans; D047829:Vietnam Conflict; D055815:Young Adult