Life after conflict-related amputation trauma: a clinical study from the Gaza Strip.
BACKGROUND
More than 17.000 Palestinians were injured during different Israeli military incursions on the Gaza Strip from 2006 to 2014. Many suffered traumatic extremity amputations. We describe the injuries, complications, living conditions and health among a selection of traumatic amputees in the Gaza Strip.


METHODS
We included 254 civilian Palestinians who had survived, but lost one or more limb(s) during military incursions from 2006 to 2016. All patients were receiving follow-up treatment at a physical rehabilitation center in Gaza at the time of inclusion. We measured and photographed anatomical location and length of extremity amputations and interviewed the amputees using standard questionnaires on self-reported health, socioeconomic status, mechanism of injury, physical status and medical history.


RESULTS
The amputees were young (median age 25,6 years at the time of trauma), well educated (37% above graduate level), males (92%), but also 43 children (17% ≤ 18 years). The greater part suffered major amputations (85% above wrist or ankle). Limb losses were unilateral (35% above-, 29·5% below knee), and bilateral (17%) lower extremity amputations. Pain was the most frequent long-term complaint (in joints; 34%, back; 33% or phantom pain; 40·6%). Sixty-three percent of amputees were their family's sole breadwinner, 75·2% were unemployed and 46% had lost their home. Only one in ten (11·6%) of the destroyed homes had been rebuilt.


CONCLUSIONS
The most frequently observed amputees in our study were young, well-educated male breadwinners and almost one in five were children. Conflict-related traumatic amputations have wide-ranging, serious consequences for the amputees and their families.
['Heszlein-Lossius|Hanne Edøy|HE|0000-0003-2371-0868', 'Al-Borno|Yahya|Y|', 'Shaqqoura|Samar|S|', 'Skaik|Nashwa|N|', 'Giil|Lasse Melvaer|LM|', 'Gilbert|Mads|M|']
D000293:Adolescent D000328:Adult D000367:Age Factors D000671:Amputation D000674:Amputees D018912:Arabs D000068337:Armed Conflicts D002648:Child D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008297:Male D008877:Middle East D012737:Sex Factors D012959:Socioeconomic Factors D011795:Surveys and Questionnaires
Trauma Military incursion Amputees, Gaza Israel Modern warfare Palestine