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Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

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Psychiatric Disease after Isolated Traumatic Upper Extremity Amputation.

Shirley Shue¹, Yuewei Wu-Fienberg², Kyle J Chepla²

¹Case Western Reserve University School of Medicine, Cleveland, Ohio, United States.

Journal of Hand and Microsurgery

|April 19, 2021

Summary

Psychiatric conditions like depression and PTSD are common after traumatic upper extremity amputation in civilians. No specific risk factors were identified, highlighting the need for surgeon awareness.

Keywords:

amputation farm prevalence psychiatric traumatic

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Area of Science:

Orthopedics
Psychiatry
Rehabilitation Medicine

Background:

Traumatic limb loss significantly impacts patient recovery and quality of life.
Psychiatric conditions are a known complication following amputation, affecting rehabilitation outcomes.
Understanding the prevalence and risk factors for psychiatric disease after upper extremity amputation is crucial for patient care.

Purpose of the Study:

To determine the prevalence of psychiatric disease in civilians following traumatic upper extremity amputation.
To identify potential risk factors associated with the development of psychiatric conditions in this patient population.

Main Methods:

Retrospective review of patient demographics, injury details, amputation level, and prosthetic use.
Analysis of International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) diagnosed psychiatric conditions and treatment duration.
Statistical analysis including descriptive statistics, Fisher's exact test, and relative risk assessment.

Main Results:

67.4% of patients (31 out of 46) had at least one diagnosed psychiatric condition.
Major depressive disorder (14 patients) and posttraumatic stress disorder (11 patients) were the most prevalent conditions.
No statistically significant correlation was found between psychiatric illness and factors such as gender, age, time since injury, employment, workers' compensation status, hand affected, or amputation level.

Conclusions:

The prevalence of depression and anxiety after traumatic upper extremity amputation in civilians mirrors rates seen after combat injuries.
Despite no identified statistically significant risk factors in this study, upper extremity surgeons must recognize the high incidence of psychiatric disease.
Awareness and screening for psychiatric conditions are essential for optimizing rehabilitation and quality of life in patients with traumatic upper extremity amputations.