Loos of bone mineral density in stump of amputee soldiers of Colombian Army, war wounded by landmines
Keywords:
lower extremity, amputation, bone density, bomb.Abstract
Objetive:
The aim of the study was to describe if traumatic amputation of lower limb caused by landmines is correlated with a lower bone mineral density at the femoral neck.
Methods
Descriptive study, realized with soldiers of the Colombian Army, lower limb amputees, who assisted at Physical Medicine and Rehabilitation service, and Prosthesis and Amputees services of
the Hospital Militar Central, in Bogota Colombia, in the period between June to November 2008. Thirty four soldiers were included, all of them were assessed by DEXA, bone mineral. density was reasure in the fe_moral neck of the healthy limb rnd the femoral neck of the stump.
Results
Sixty\four limbs were assessed, 54 were classified as normal (79,4%), osteopenia was found in 14,7% of cases and osteoporosis in 5,9%. The mean of bone mineral density in the femoral neck of the healthy limb was 1074 mg/cm2, compared with 892,29 mg/cm2 in the stump, this difference was statistical significant (t=4,75 p = 0,00). Association b1~tween abnormal bone mineral density (osteopenia, osteoporosis) in the stump and the healthy limb was found (chi square 17,6 p= 0,00). Relationship between time elapsed since amputation and abnormal bone mineral density (osteopenia, osteoporosis)
was not found.
Conclusions
Bone mineral density measured in the femoral neck of stump and the heallthy limb-was significant different. A statistical si~gnificance difference was found between the amputation and
the presence of osteopenia and osteoporosis in the femoral neck. Relationship between time elapsed since amputation and abnormal bone mineral density (osteopenia, osteoporosis) was
not found.
References
P. Rush, J. Wong, J. Kirsh, and M. Devlin, Osteopenia in patients with above knee amputation. Arch. Phys. Med. Rehabil. 1994; 75, 112-115.
Daldn N., HellstrOm L.-G, and Jacobson B. Bone mineral content and mechanical strength of the femoral neck. Acta Orthop Scand 1976;47:503 508.
Burke MJ, Roman V, Wright V. Bone and joint changes in lower limb amputees. Ann Rheum Dis. 1978;37:252-4.
Minaire P. Immobilization osteoporosis: A review. Clin Rheumatol. 1978; 8(Suppl. 2):95-1 03. 1989.
Lilley J.,Wahers B. G., Heath D. A. and Drolc. Z. Comparison and investigation of bone mineral density in opposing femora by dual energy X-ray absorptiometry. Osteopor Int. 1992.; 2:274-278.
Kulkarni J, Adams J. Association between amputations, arthritis and osteopenia in british male veterans with major lower limb amputations. Clin Rehab. 1998; 12: 274-279.
Leclercq MM, Study of bone mass with dual energy x ray absorptiometry in a population of 99 lower limb amputees. Ann Readapt Med. Phys. 2003;46 (1):24-30.
Royer T., Koening M. Joint Loading and bone mineral density in persons with unilateral, transtibial amputation. Clin Biomech. 2005; 20:1119-1125.
Kamil Y Osteoporosis: A factor on residual limb pain in traumatic transtibial amputations. Protesis and orthosis International. 2008.
