Intermediate rehabilitation outcome in below-knee amputations: Descriptivestudy comparing war-related with other causes of amputation

Aim. To asses the intermediate rehabilitation outcome of patients with war- related below-knee amputations and compare it with the patients with other causes of amputation. Method. The study comprised 74 patients with below-knee stumps admitted for rehabilitation at the Department of Physical Therapy and Rehabilitation, S plit University Hospital, Croatia, in 1994. They were fitted with a prelimi nary prosthesis, a donation from the Finish Red Cross. The rehabilitation w as performed by a professional team and included regular bandaging of the s tump, exercises to prevent knee and hip joint contracture, general fitness exercises, standing-up, falling and walking exercises, and electrostimulati on of the thigh muscles. The time to reach each rehabilitation phase (walki ng with 2 crutches, walking with 1 crutch, walking with no crutches) was me asured. The satisfaction of the patients with the prosthesis was also asses sed at the end of rehabilitation. Results. Among 74 patients with below knee amputation, war trauma was the c ause for amputation in 31 patients, and in 6 of them the amputations were b ilateral. Patients with war-related below-knee amputations were younger tha n the patients with amputations related to vascular disease, including diab etes. The rehabilitation time was significantly shorter in patients with wa r-related amputations (61.1 +/- 11.4 days to walking with no crutches) comp ared with patients with vascular disease-related amputations (80.9 +/- 8.1 days; p<0.001). The satisfaction with the prosthesis was more variable in p atients with war-related amputations than in other patients. Conclusion. Early physical rehabilitation and replacement of the lost extre mity with a preliminary prosthesis is an optimal intervention in below-knee amputations due to war-injury. Special attention should be paid to the psy chological support to these patients during rehabilitation therapy.