Long Term Management of the Military Amputee

Description

This presentation, led by Tania Cubison, focuses on the surgical management of military amputees, particularly those returning from Afghanistan. The discussion begins with an overview of the initial treatment protocols, which emphasize wound debridement followed by patient evacuation to specialized facilities such as the Birmingham Queen Elizabeth Hospital where further physiological support and soft tissue reconstruction occur. The speaker shares insights from her extensive experience since 2009 in managing military and civilian amputees, highlighting the challenges faced due to high-energy injuries and complications like excess bone growth and neuroma development.



A significant part of the talk covers the innovative technique of targeted muscle reinnervation (TMR), which she adopted in 2019, emphasizing its role in alleviating phantom limb pain and improving postoperative satisfaction. TMR involves leveraging the neuroanatomy of amputees to promote better nerve signaling and reduce pain, providing a more integrated approach to managing both residual limb pain and neuromas.



Cubison illustrates her findings based on patient outcomes, noting that while many individuals report substantial pain relief and improved quality of life post-surgery, the process of reinnervation takes longer in older patients with comorbid conditions. She stresses the importance of personalized patient care, discussing various surgical approaches for pain management, and the holistic rehabilitation process she oversees, which includes both physical and mental health considerations. This talk encapsulates the evolving strategies in managing post-amputation discomfort, revealing both challenges and successes in contemporary limb salvage and reconstruction practices.

DOI: 10.1302/3114-230054

Specialties