Long-term follow-up of Iranian veteran upper extremity amputees from the Iran-Iraq war (1980-1988).

BACKGROUND Despite their frequency, there are limited reports concerning long-term follow up of upper limb amputation among battle-injured patients, which occurred at a young age. The purpose of this study was to evaluate how well these patients function years after their injury. METHODS The study consisted of a thorough assessment and examination and review of the history and war time medical records of 25 Iranian veteran amputees from imposed Iran-Iraq war with a comprehensive survey including a detailed questionnaire. Information was analyzed and compared with limited similar reports in the literature. RESULTS Out of 200 war amputees there were 25 unilateral upper limb amputees; all others were lower limb amputees. The average age at the time of injury was 23.06 years, average age at follow-up was 41.55 years, and the average time between injury and follow-up was 17.5 years. The most common level of amputation was below elbow (40%), and the most common cause of war injury was artillery shells, mortar or rocket shells. The prevalence of clinical symptoms of phantom sensation, phantom pain, phantom movement and stump pain were; 64%, 32%, 20%, 24%, respectively. All patients were married (100%) and had children except one case (96%). Sixty percent of patients were employed. Thirty-six percent had a documented psychiatric history ranging from minor depression to posttraumatic stress disorders. CONCLUSION The study showed-despite long period of time between war, amputation, and follow-up-there is a significant rate of amputation symptoms, but on the other hand good family and social function of the patients.