[Subjective impairment after macroamputation of the upper extremity].

BACKGROUND

The subjective outcome following macroamputation of the upper limb was evaluated using the DASH score.

PATIENTS AND METHODS

In a retrospective study, 11 patients with stumps of the upper limb following trauma were investigated 5.6 years after injury. Data according to injury pattern, age, gender, level of amputation and DASH score were collected.

RESULTS

Included are 2 unilateral and 3 bilateral forearm amputees and 6 patients with upper arm amputation. Only males were seen with a mean age of 32 years. Amputation occurred following polytrauma in 3 cases while in the other 8 cases the amputated limb was unreconstructably mangled. 8 patients wear a prosthesis. 4 (36 %) patients are unemployed. The mean DASH score was 44.8, in bilateral forearm amputees 74.16, in unilateral upper-arm amputees 38.47 and in unilateral lower forearm amputees 43.33. Patients with bilateral amputation showed the greatest functional and social impairment. Mean pain was 40 % of the pain section in the DASH questionnaire and showed no difference with regard to the level of amputation or bilateral injury. All patients are socially integrated. Patients with unilateral amputation rated psychological impairment higher than functional impairment.

CONCLUSION

Patients with macroamputation of the upper extremity show high psychological and functional impairment. Pain, deficits in function and still not optimal prosthetic devices result in a high percentage of unemployment.