Upper Extremity Injuries and Correlates with Amputation Outcome following Combat Trauma John J Carroll, MD Peter C Rhee, DO Jessica C Rivera, MD US Army Institute of Surgical Research And San Antonio Military Medical Center Department of Orthopaedic Surgery
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Upper Extremity Injuries and Correlates with Amputation Outcome following Combat Traumallrs.org/LLRS 2016 PDFS/Upper Extremity Injuries and... · 2017-10-19 · Upper Extremity Injuries
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Upper Extremity Injuries and Correlates with Amputation Outcome
following Combat Trauma
John J Carroll, MD Peter C Rhee, DO
Jessica C Rivera, MD
US Army Institute of Surgical Research And
San Antonio Military Medical Center Department of Orthopaedic Surgery
The author have no disclosures to report related to this work. The authors acknowledge the Department of Defense Trauma Registry (DoDTR) for providing data for this study. The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
• UE amputations 14% of OIF/OEF combat amputations
• Predictors of UE amputations less explored compared to LE
• Vascular status not predictive
Tennent D, et al. Characterization and outcomes of upper extremity amputations. Injury, 2014; 45(6): 965-9. Prichayudh S, et al. Management of upper extremity vascular injury: outcome related to the Mangled Extremity Severity Score. World J Surg, 2009; 33(4): 857-63 MacKenzie EJ, et al. Characterization of patients with high-energy lower extremity trauma. J Orthop Trauma, 2000; 14(7): 455-66.
• 25% frequency of muscle conditions following extremity injury
• High percent disability despite “successful” healing of limb
• Muscle disability increases with time
0 365 730 1095 1460 1825 2190
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TPI (days)
% D
isab
ility
Initial Final (With Initial Rating)Initial Final (With no Initial Rating)
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Subject
% D
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ility
A
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Corona BT, Rivera JC, Owens JG, Wenke JC, Rathbone CR. Volumetric muscle loss leads to permanent disability following extremity trauma. J Rehabil Res Dev, 2015; 52(7): 785-92. Rivera JC, Corona BT. Muscle-related disability following combat injury increases with time. US Army Med Dep J, 2016; Jan-Mar: 30-34.