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The Northern Ireland troubles and limb loss: a retrospective study
1Regional Disablement Service, Musgrave Park Hospital, Belfast, Northern Ireland. lorradam@yahoo.com
Insights
This study analyzes limb amputations from the Northern Ireland Troubles (1969-2003). Car bombs were the most frequent cause of injury, with trans-femoral amputations being most common.
Area of Science:
- Trauma surgery
- Rehabilitation medicine
- Conflict studies
Background:
- The Troubles in Northern Ireland resulted in widespread violence and civilian casualties.
- Limb loss due to conflict injuries presented significant rehabilitation challenges.
- Regional Disablement Services provided prosthetic fitting for individuals with amputations.
Purpose of the Study:
- To present patient demographics of survivors with limb amputations caused by the Troubles.
- To identify causes of injury, amputation levels, and associated injuries.
- To analyze prosthetic fitting timelines and reasons for delays.
Main Methods:
- Retrospective review of patient records from 1969 to 2003.
- Data collection on patient demographics, injury details, and prosthetic fitting.
- Analysis of amputation levels, associated injuries, and time to prosthetic fitting.
Main Results:
- 129 patients (110 male, 19 female) sustained amputations; 72 were civilians.
- Car bombs were the most common cause of injury; trans-femoral amputations were most frequent.
- 67% had associated injuries; 32 patients experienced delays of 6+ months in prosthetic fitting.
Conclusions:
- The study highlights the long-term impact of the Troubles on individuals requiring prosthetic rehabilitation.
- Understanding injury patterns and rehabilitation delays is crucial for optimizing care for conflict survivors.
- Car bomb injuries significantly contributed to limb loss and long-term disability in Northern Ireland.
Abstract:
The Troubles in Northern Ireland have now lasted 34 years. Divisions and strife between the opposing loyalist and republican communities, and between the communities and the security forces, have led to thousands of deaths and injuries. The violence has often been indiscriminate injuring and killing totally innocent people. Staff at the Regional Disablement Services at Musgrave Park Hospital, Belfast have had the responsibility for helping to rehabilitate those who have suffered limb loss, both civilians and security forces personnel. In this study the authors present patient demographics for those survivors, referred for prosthetic fitting, who have sustained limb amputations as a result of the Troubles from 1969 to 2003, with the cause of injury, resulting levels of amputation, associated injuries, time to first prosthetic fitting and reason for any delay in fitting identified. One hundred and twenty-nine (129) patients sustained amputations, 110 male and 19 female with an age range at the time of injury from 7 to 60 years. Seventy-two (72) were civilian. Ninety-three (93) underwent immediate amputation, the most frequent level of amputation being trans-femoral. Delayed healing of deep wounds was the most common reason for delayed amputation; other causes were chronic osteomyelitis, malunited fractures and failed arthrodesis, often associated with chronic pain. Ninety-two (92) patients required amputation of one limb or part thereof, 35 required amputation of 2 limbs and 2 underwent triple amputation. Three (3) patients lost both hands. Sixty seven percent (67%) had other associated physical injuries. Thirty-two (32) patients had a delay of 6 months or more in fitting a prosthesis. The most common cause of injury was the car bomb.