Bilateral lower limb amputations as a result of landmine injuries

Landmine explosions cause most of the war injuries in the battlefield. Ampu tations resulting from severe injuries reveal serious problems despite the improvements in surgery. Bilateral lower limb amputations have more impact than unilateral on social life. Some 29 cases with lower limb amputations due to landmine injuries were tre ated in the Department of Orthopaedics and Traumatology, Gulhane Military M edical Academy between January 1992 and December 1996. Amputation levels we re as follows: 1 case had hip disarticulation and a trans-femoral amputatio n, 6 had bilateral trans-femoral amputations, 6 had trans-femoral and trans -tibial amputations, 12 had bilateral trans-tibial amputations, 1 had trans -femoral and Chopart amputations and the remaining 3 cases had trans-tibial and Chopart amputations. The initial treatment was done for all cases in the first 6-8 hours after i njury at the field hospitals. Aggressive debridement, excision and primary closure were performed. None of the stumps required reamputations and/or re vision. No case had gas gangrene or tetanus. Postoperative, pre-prosthetic training programme which ranged between 30-12 0 days with an average 48 days; and prosthesis fitting and adequate post-pr osthetic training programme which ranged 32-126 (average 94) days was appli ed. All the cases were followed-up with a mean of 38.5 months (14-72 months ). Nine (9) cases (31%) returned to their previous occupation, while 20 (69 %) cases had to change their jobs.