Transtibial amputees from the Vietnam War - Twenty-eight-year follow-up
Transtibial amputees from the Vietnam War - Twenty-eight-year follow-up
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DOI：
10.2106/00004623-200103000-00010
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发表时间：
2001-03-01
影响因子：
5.3
通讯作者：
Dougherty, PJ
中科院分区：
文献类型：
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作者：
Dougherty, PJ
背景：下肢截肢后的长期功能结果没有很好的记录。我确定的功能结果和健康状况的患者谁持续了单侧transtibial截肢的结果，战场injuries.Methods：123例曾在福吉谷谷陆军总医院在越南战争期间的诊断孤立transtibial截肢由于战场损伤的记录进行了审查。第1组进行了单独的经胫骨截肢，第2组除了经胫骨截肢外，还至少有一处其他严重损伤（下肢另一处严重长骨骨折，烧伤面积超过体表面积的20%，或胸部、腹部、面部或头部伤口）。72例（59%）患者入组研究：第1组28例，第2组44例。资料收集有关就业状况，婚姻状况，是否有孩子，并利用心理支持服务。使用简明健康调查量表（SF-36）将第1组和第2组与年龄和性别匹配的对照组进行单独和合并比较。两组（对照组和截肢组）的量表得分进行了比较，使用学生t检验（双尾）。结果：绊倒地雷或诱杀装置造成65%的伤害。随访时的平均年龄为48岁。平均随访时间为28年。只有心理支持服务的使用率在第1组和第2组之间存在显著差异（21%与50%; p = 0.015）。第1组和第2组的SF-36健康调查结果分别为：身体功能81.6和58.2，身体角色82.7和33.1，身体疼痛81.4和50.9，一般健康74.1和58.7，活力67.1和51.5，社会功能89.1和70.4，情感角色得分为88.1和56.0，心理健康得分为79.5和64.0。第1组的平均评分相似的年龄和性别匹配的对照组，但第2组的分数显着低于（p小于或等于0.001）比那些年龄和性别匹配的对照组在所有category.Conclusions：第1组的患者导致相对正常的生活后，持续在战斗中的transtibial截肢。增加另一个重大损伤（第2组）似乎对SF-36评分和心理护理的需求有显著的长期影响。
Background: The long-term functional outcome following lower-extremity amputation is not well documented. I ascertained the functional outcome and health status of patients who had sustained a unilateral transtibial amputation as a result of a battlefield injury.Methods: The records of 123 patients who had been treated at Valley Forge Army General Hospital during the Vietnam War for a diagnosis of isolated transtibial amputation due to a battlefield injury were reviewed. Group 1 had an isolated transtibial amputation, and Group 2 had at least one other major injury (another major long-bone fracture of the lower extremity, burns covering >20% of the body surface area, or a chest, abdominal, face, or head wound) in addition to the transtibial amputation. Seventy-two (59%) of the patients were enrolled in the study: twenty-eight were in Group 1 and forty-four, in Group 2. Data were collected about employment status, marital status, whether the patient had children, and use of psychological support services. The Short Form-36 (SF-36) health survey was used to compare Group 1 and Group 2, individually and combined, with age and gender-matched controls. Scaled scores for the two groups (control and amputation) were compared with use of the Student t test (two-tailed).Results: Tripping a land mine or booby trap caused 65% of the injuries. The average age at the time of follow-up was forty-eight years. The average time to follow-up was twenty-eight years. Only the prevalence of the use of psychological support services differed significantly between Groups 1 and 2 (21% compared with 50%; p = 0.015). The results of the SF-36 health survey for Groups 1 and 2 were 81.6 and 58.2, respectively, for physical function, 82.7 and 33.1 for role physical, 81.4 and 50.9 for bodily pain, 74.1 and 58.7 for general health, 67.1 and 51.5 for vitality, 89.1 and 70.4 for social function, 88.1 and 56.0 for role emotional, and 79.5 and 64.0 for mental health. The average scaled scores for Group 1 were similar to those for the age and gender-matched controls, but the scores for Group 2 were significantly lower (p less than or equal to 0.001) than those for the age and gender-matched controls in all categories.Conclusions: Group-1 patients led relatively normal lives after sustaining a transtibial amputation in battle. The addition of another major injury (Group 2) appears to have significant long-term consequences with regard to SF-36 scores and the need for psychological care.