Return to Duty and Disability After Combat Related Hindfoot Injury
SAN ANTONIO MILITARY MEDICAL CENTER FORT SAM HOUSTON TX
Pagination or Media Count:
Objectives To characterize the return-to-duty RTD rates and disability outcomes for soldiers who sustained combat-related hindfoot injuries that were treated with either reconstruction or transtibial amputation TTA. Design Retrospective cohort series. Setting Tertiary trauma center. PatientsParticipants All patients treated for combat-related hindfoot injuries between May 2005 and July 2011. Intervention TTA or hindfoot reconstructionankle fusion. Main Outcome Measurements Age, RTD rate, combined disability, and associated disabling conditions. Results One hundred twenty-two patients underwent treatment for combat-related hindfoot injuries. Fifty-seven patients were treated with amputation, and 65 patients were treated with hindfoot reconstruction or ankle fusion. The overall RTD rate was 20. Amputees had a RTD rate of 12, which was lower than those who had a fusion or hindfoot repair 26 P , 0.06. The disability ratings of amputees were significantly higher than those patients undergoing either ankle fusion or primary hindfoot repair 75 and 62, respectively P , 0.006. Discussion While RTD rates were higher for hindfoot reconstruction or ankle fusion compared with TTA, psychiatric conditions were more common among these patients. Although there were clear differences between both groups, the relationship between true functional outcomes and disability ratings remains unclear and both treatment groups seem to do poorly in terms of returning to active duty.
- Anatomy and Physiology
- Medicine and Medical Research
- Military Forces and Organizations