EXTENT OF DISABILITY FOLLOWING TRAUMATIC EXTREMITY AMPUTATION

Extremity amputation is a devastating injury. Forty-two patients who s ustained traumatic limb amputation were contacted 3-57 months (mean, 2 5 months; median, 24 months) after injury to evaluate residual disabil ity and to determine what factors were associated with a good recovery . There were 35 men and 7 women with ages ranging from 5 to 73 years ( mean, 34 years). Amputation was the result of a motor vehicle crash in 18, work-related injury in 11, motorcycle crash in 9, and other cause s in 4. There were 46 amputations done: 8 above-knee (AK), 25 below-kn ee (BK), 5 above-elbow (AE), and 9 below-elbow (BE). Twenty patients r eported no problems with their prosthesis, 8 had major (e.g., infectio ns) and 6 had minor (e.g., skin breakdown) problems. Eight patients di d not receive or did not use a prosthesis. Fourteen patients were disc harged to an inpatient rehabilitation facility, 25 to home with outpat ient rehabilitation, and 3 had no rehabilitation. Of those who worked before their injury, only 50% returned to work. The mean and median ti me to return to work were 14 and 12 months, respectively. Three of fiv e full-time students returned to school. The amputation level in patie nts returning to work or school was BK in 12, BE in 3, and AE in 1. No patient with a AK amputation and only 1 (9%) patient with a work-rela ted injury returned to work. Associated injuries or inpatient rehabili tation did not correlate with returning to work. Eighty-eight percent of patients were satisfied with their adjustment and could perform all activities of daily living. While physical rehabilitation of patients sustaining traumatic amputation may be acceptable, the rate of return to work is poor. More aggressive vocational retraining is needed to a void permanent disability and unemployment.