Journal of Rehabilitation Research & Development (JRRD)

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Volume 52 Number 1, 2015
   Pages 53 — 62

Abstract — Identifying obstacles to return to duty in severely injured combat-related servicemembers with amputation

Richard K. Hurley Jr, MD;1* Jessica C. Rivera, MD;2 Joseph C. Wenke, PhD;3 Chad A. Krueger, MD2

Departments of 1Orthopaedic Surgery, and 2Orthopaedics and Rehabilitation, San Antonio Military Medical Center, Fort Sam Houston, TX; 3Department of Regenerative Medicine, Institute of Surgical Research, Fort Sam Houston, TX

Abstract — The capacity of servicemembers with amputation to return to duty after combat-related amputation and the associated disabilities remains largely unknown. The purpose of this study was to examine the disabling conditions and return to duty rates of servicemembers with amputation across all service branches following major limb amputations from September 2001 through July 2011. Pertinent medical information, military occupation status, return to duty designation, disabling conditions, and disability ratings for each servicemember were obtained from the Physical Evaluation Board Liaison Office (PEBLO). Across all service branches, 16 (2%) servicemembers were found fit for duty (Fit) and allowed to continue with their preinjury occupation. Another 103 (11%) were allowed to continue on Active Duty (COAD) in a less physically demanding role. More than half (554, 56%) were determined fully disabled (PEBLO rating > 75); the average disability rating was 73. COAD and Fit Army servicemembers had lower Injury Severity Scores than other servicemembers (17.4, p = 0.009 and 11.2, p < 0.001, respectively). Despite improvements in their care and rehabilitation, only 13% of all servicemembers with amputation are able to return to Active Duty and many have multiple disabling conditions that contribute to a very high level of disability.

Key words: Active Duty, amputation, combat, combat-related amputation, disability, disability rating, Injury Severity Score, physician evaluation liaison board, rehabilitation, return to duty.


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This article and any supplementary material should be cited as follows:
Hurley RK Jr, Rivera JC, Wenke JC, Krueger CA. Identifying obstacles to return to duty in severely injured combat-related servicemembers with amputation. J Rehabil Res Dev. 2015;52(1):53–62.
http://dx.doi.org/10.1682/JRRD.2014.04.0094

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