JRRD, Volume 47, Number 4, 2010
Table 2. Comparison of level of major traumatic lower-limb loss by number and percentage (%) among wheelchair users who abandoned prosthetic devices in Vietnam and Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) groups.
Amputation Lev Vietnam
Other Multiple-Limb Loss
Including 1 Lower Limb
p < 0.05 compared with other limb loss levels within group.
Excludes one upper limb.
1 (50) 1 (50) 0 0 2†
0 28 (93.3) 1 (3.3) 1 (3.3) 30
different by level of limb loss, but this finding may be due to this group’s short time since limb loss. For those abandoning prostheses in favor of wheelchairs in the Vietnam group, 65 percent were manual wheelchairs, 26 percent were electric chairs, and 9 percent are electric scooters (data not shown). Most of the OIF/OEF group use a manual chairs (88%) or electric scooters (12%) after abandoning prostheses.
The mean time until abandonment of all prosthetic devices were assessed in the three limb-loss groups with each conflict group. Abandonment times are significantly different by type of limb loss (Figure). However, abandon- ment patterns may change as the OIF/OEF group ages to reflect the Vietnam group patterns. When similar time periods are compared (1–3 years postamputation), the Vietnam group still used their devices significantly longer (1.7 years) before abandonment compared with the OIF/ OEF group (0.6 years). For those with unilateral lower- limb loss, Vietnam war veterans used prosthetic devices for an average of 13.9 ± 13.7 years before discontinuing them, whereas the OIF/OEF participants abandoned them after only 0.6 ± 0.4 years, p < 0.001. For those with bilat- eral lower-limb loss, both conflict groups abandoned pros- thetic devices more rapidly than those with unilateral lower-limb loss. The Vietnam group used lower-limb pros- thetic devices longer on both limbs before abandoning them
± 8.6 years) compared with the OIF/OEF group (0.3 ±
years, p < 0.001). For those with multiple-limb loss,
prostheses were abandoned within the first year for both the Vietnam and OIF/OEF groups.
Figure. Mean years of prosthetic device use until prosthetic device abandon- ment by Vietnam and Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) groups for three types of limb loss.
The principle reasons prostheses were abandoned in favor of wheelchair use are also examined (Table 3). In the Vietnam group with unilateral lower-limb loss, 42 percent abandoned prostheses because of cumulative trauma disorder. In contrast, the most frequent reason in the OIF/OEF group with unilateral lower-limb loss was combat injuries to the nonamputated lower limb (50%). For those with bilateral lower-limb loss, the most common reasons in the Vietnam group were short length of the residual limb (33%) and pain (25%). However, in the OIF/OEF group with bilateral lower-limb loss, the rea- sons were too much fuss (50%) or needing arms for daily