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Long-Term Clinical Outcomes of War-Related Hip Disarticulation and Transpelvic Amputation
Mohamad H. Ebrahimzadeh, MD1; Amir Reza Kachooei, MD1; Mohamad Reza Soroush, MD2; Ebrahim Ghayem Hasankhani, MD1; Shiva Razi, MD1; Ali Birjandinejad, MD1
1 Orthopaedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, 91766-99199 Iran. E-mail address for M.H. Ebrahimzadeh: Ebrahimzadehmh@mums.ac.ir. E-mail address for A.R. Kachooei: kachoeear@mums.ac.ir. E-mail address for E.G. Hasankhani: hasankhanie@mums.ac.ir. E-mail address for S. Razi: Razi.shiva@gmail.com. E-mail address for A. Birjandinejad: birjandinejada@mums.ac.ir
2 Biomedical Research Institute, Moghadas–Ardabili Avenue, Chamran Highway, Tehran, Iran
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  • Disclosure statement for author(s): PDF

Investigation performed at Mashhad University of Medical Sciences, Mashhad, Iran

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Aug 21;95(16):e114 1-6. doi: 10.2106/JBJS.L.01160
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The Iran-Iraq war (1980 to 1988) was one of the longest wars of the twentieth century. Few studies are available in the current literature evaluating the long-term results of proximal lower-extremity war-related amputations. The purpose of the present cross-sectional study was to evaluate the current health-related quality of life and clinical musculoskeletal function of Iranian veterans with hip or hemipelvic amputation.


Seventy-six patients from a cohort of eighty-four veterans with hip disarticulation and transpelvic amputation participated in this study. A Persian version of Medical Outcomes Study Short Form-36 (SF-36) was completed for all of the veterans.


The average duration of follow-up was 26.6 ± 3.7 years. The average age (and standard deviation) of the veterans was 44.1 ± 7.0 years. The average scores for the physical and mental health dimensions of the SF-36 were 45.85 ± 21.56 and 57.98 ± 25.19, respectively. These data indicate that the amputees were doing better in the mental domain than in the physical domain. Forty-five patients with a primary amputation (97.8%) and ten with a secondary amputation (33.3%) complained of pain in the amputation stump.


Veterans with proximal lower-extremity amputation will need life-long care. Supervision starts with stump management and the application of appropriate surgical techniques at the time of the injury and continues with periodic examination throughout life.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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