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2016 ; 3
(ä): 34
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A comprehensive musculoskeletal and peripheral nervous system assessment of
war-related bilateral upper extremity amputees
#MMPMID27891243
Allami M
; Mousavi B
; Masoumi M
; Modirian E
; Shojaei H
; Mirsalimi F
; Hosseini M
; Pirouzi P
Mil Med Res
2016[]; 3
(ä): 34
PMID27891243
show ga
BACKGROUND: Upper limb amputations are one of the unpleasant war injuries that
armed forces are exposed to frequently. The present study aimed to assess the
musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with
bilateral upper extremity amputation. METHODS: The study consisted of taking a
history and clinical examinations including demographic data, presence and
location of pain, level of amputation, passive and active ranges of movement of
the joints across the upper and lower extremities and spine, manual palpation,
neurological examination, blood circulation pulses and issues related to a
prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees
(206 amputations) from the Iran-Iraq war were evaluated, and a detailed
questionnaire was also administered. RESULTS: The most common level of amputation
was the finger or wrist level (108, 52.4 %). Based on clinical examination, we
found high frequencies of limited active and passive joint range of movement
across the scapula, shoulder, elbow, wrist and metacarpophalangeal,
interphalangeal and thumb joints. Based on muscle strength testing, we found
varying degrees of weakness across the upper limbs. Musculoskeletal disorders
included epicondylitis (65, 31.6 %), rotator cuff injury (24, 11.7 %), bicipital
tendonitis (69, 33.5 %), shoulder drop (42, 20.4 %) and muscle atrophy (19,
9.2 %). Peripheral nerve disorders included carpal tunnel syndrome in 13 (6.3 %)
and unilateral brachial plexus injury in 1 (1 %). Fifty-three (51.5 %) were
diagnosed with facet joint syndrome at the level of the cervical spine (the most
frequent site). Using a prosthesis was reported by 65 (63.1 %), both left and
right sides. The back was the most common site of pain (71.8 %). CONCLUSION: The
high prevalence of neuro-musculoskeletal disorders among bilateral upper
extremity amputees indicates that they need regular rehabilitation care.