Comprehensive rehabilitation of a serviceman with triple limb amputation following combat polytrauma: a case study from Ukraine's wartime context

Abstract: The ongoing war in Ukraine has led to a significant rise in combat-related polytrauma injuries, including high-level multiple amputations, delayed evacuations, infectious complications, and limited access to rehabilitation services. This clinical case demonstrates a comprehensive, patient-centred approach to the rehabilitation of a 25-year-old serviceman with triple amputations caused by a mine-blast injury. The patient progressed through pre-prosthetic and prosthetic rehabilitation stages, achieved independent mobility with prosthetics, transitioned to the K3 functional level, and adapted to his independent life. The success of this case underscores the importance of a multidisciplinary approach, modern technologies, and adherence to evidence-based rehabilitation practices. The leading role of the physical and rehabilitation medicine physician was pivotal in coordinating and adjusting the rehabilitation process, ensuring the optimal use of available resources, and aligning the patient's care with clinical goals. Challenges such as delays in rehabilitation initiation and limited resources highlight the need to expand inpatient rehabilitation capacity and standardize protocols. A coordinated bio-psycho-social rehabilitation model must be the framework for increasing the effectiveness of rehabilitation services and optimizing functioning and quality of life after severe injuries. Implementing multidisciplinary approaches tailored to wartime settings is crucial for combatants' effective recovery and reintegration.

Read the full article
Report a problem with this article

Related articles

  • More for Researchers

    Qualitative analysis of the lived experience of reproductive and pediatric health care in the military health care system

    Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.