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Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Published on: October 29, 2021

Postoperative Psychiatric Outcomes After Upper-Extremity Amputations.

Christopher M Dussik¹, Amy Phan¹, Jeffrey Coombs¹

¹Department of Orthopaedic Surgery, University of Rochester School of Medicine, Rochester, NY.

The Journal of Hand Surgery

|April 26, 2025

Summary

This summary is machine-generated.

Upper extremity amputations significantly increase the risk of psychiatric conditions, with more proximal amputations leading to a greater incidence of mental health issues compared to distal ones.

Keywords:

Amputation depression post-traumatic stress disorder psychiatric outcomes upper extremity

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Area of Science:

Orthopedics
Psychiatry
Public Health

Background:

Upper-extremity amputations significantly impact patient form and function, particularly proximal amputations.
Previous psychological outcome studies were limited to single institutions.

Purpose of the Study:

To assess the population-wide incidence of psychiatric conditions following upper-extremity amputations.
To compare psychiatric outcomes across different amputation levels.

Main Methods:

Utilized the TriNetX database for patients undergoing upper-extremity amputations (2010-2022).
Analyzed 3-year incidence of mental health conditions using International Classification of Diseases codes.
Compared outcomes to the general and upper extremity surgical populations using chi-squared tests and odds ratios.

Main Results:

25,091 patients underwent 25,415 upper-extremity amputations, with trauma as the most common cause.
Amputations at or proximal to the wrist showed increased rates of depression, anxiety, psychosis, mood disorders, substance abuse, PTSD, and suicidality compared to hand-only amputations.
All psychiatric outcomes, except general anxiety disorder, were higher post-amputation compared to the general population.
Patients with amputations proximal to the phalanges had increased odds of psychiatric illness compared to those undergoing non-amputation upper extremity surgery.

Conclusions:

Approximately 1 in 6 patients develop a psychiatric condition within 3 years of upper extremity amputation.
The incidence of psychiatric conditions is elevated post-amputation compared to the general population.
More proximal amputations are associated with a higher burden of psychiatric illness.