Objective: To describe the incidence of overuse musculoskeletal injuries in service members with combat-related lower limb amputation.
Design: Retrospective cohort study.
Setting: Military treatment facilities.
Participants: Service members with deployment-related lower limb injury (N=791): 496 with a major lower limb amputation and 295 with a mild lower limb injury.
Interventions: Not applicable.
Main outcome measures: The outcomes of interest were clinical diagnosis codes (International Classification of Diseases-9th Revision) associated with musculoskeletal overuse injuries of the lumbar spine, upper limb, and lower limb regions 1 year before and 1 year after injury.
Results: The overall incidence of developing at least 1 musculoskeletal overuse injury within the first year after lower limb amputation was between 59% and 68%. Service members with unilateral lower limb amputation were almost twice as likely to develop an overuse lower or upper limb injury than those with mild combat-related injury. Additionally, service members with bilateral lower limb amputation were more than twice as likely to develop a lumbar spine injury and 4 times more likely to develop an upper limb overuse injury within the first year after amputation than those with mild combat-related injury.
Conclusions: Incidence of secondary overuse musculoskeletal injury is elevated in service members with lower limb amputation and warrants focused research efforts toward developing preventive interventions.
Keywords: Amputation; Pain; Rehabilitation.
Published by Elsevier Inc.