Rehabilitation of a US Army Soldier With Traumatic Triple Major Limb Amputations: A Case Report

Abstract

In Brief A 22-year-old male US Army soldier injured during combat operations in Iraq. The soldier was struck by a rocket propelled grenade and his life was saved through the efforts of fellow infantrymen, combat medics, and combat support hospital staff. His treatment crossed international boundaries from Iraq, Germany, and to the United States. He arrived in Washington, DC, on the sixth day after his injury. The following amputations were performed: left transradial amputation, right hip disarticulation, and left knee disarticulation. He was fitted with a myoelectric arm, a body-powered arm, and a passive/cosmetic arm along with multiple terminal devices. He was also fitted with a right bucket hip socket and left thigh ischial containment socket with bilateral C-legs. At 1-year postinjury, the patient was functioning at a modified independent level for mobility, transfers, ambulation, and activities of daily living. He was able to walk using axillary crutches for community distances. He had exceeded all initial functional goals. Rehabilitation of a triple amputee is an uncommon challenge that will likely become more common with the improved survivability of the modern battlefield (increased protection of personal body armor, advanced training of combat medics, forward positioned surgical trauma teams, rapid medical evacuation out of theater, and advanced lifesaving techniques). As more patients with severe, multiple trauma and amputations survive, there will be a greater need for innovative and comprehensive interdisciplinary approaches to their life-saving acute care and lifelong rehabilitation. A US Army soldier who was struck by a rocket-propelled grenade in Iraq underwent a left transradial amputation, a right hip disarticulation, and left knee disarticulation. He was fitted with a myoelectric arm, a body-powered arm, and a passive/cosmetic arm, along with multiple terminal devices. He also was fitted with a right bucket hip socket and left thigh ischial containment socket with bilateral Otto Bock C-Legs. At one year post-injury, he had exceeded all initial functional goals.