Persian Gulf War amputees: injuries and rehabilitative needs

This study describes the injuries, complications, functional limitations, and rehabilitative needs of amputees managed at Walter Reed Army Medical Center during the Persian Gulf conflict (1991). Fourteen amputees were treated sustaining 21 amputations with 18 lower-limb and 3 upper-limb amputations. In six casualties there were multiple amputations. Battle injuries were the cause in 79%. Nerve injuries occurred in 79%, phantom pain in 64%, and functional limitations (ambulation and activities of daily living [ADLs]) were present in all casualties. Contractures were noted in 86%. Skin traction for open wounds was lacking in all but one case. With comprehensive rehabilitation, all casualties achieved independent ambulation, and 93% were independent in all ADLs at discharge, with one below-knee amputee successfully returning to duty. These findings highlight the need for education of military health care providers in skin traction techniques, and provision of multidisciplinary rehabilitative care for these casualties.