In the study of land mine amputees we found rates of phantom pain at 68%. Ten amputees said the phantom pain was stable, seventeen said it was increasing. The rate of amputation stump pain were 43% in Cambodia, 76% in Northern Iraq. Nineteen amputees said the stump pain was stable, eight said it was still increasing more than one year after the accident. There was no correlation between amputation stump quality and levels of chronic pain. However, self-rated loss of post-injury income did correlate with rates of phantom limb pain (p< .05).
Relief organizations provide nice polypropylene prosthesis for the amputees at professional centers.
But definitive prosthesis fitting takes place 4 – 6 months after the injury. In the meantime amputees have to sit waiting in their villages. If they at all can afford to take a two week travel to the city.
Hypothesis: That is not a professional strategy. To encourage coping we should get the amputees going immediately after injury and surgery.
At TCF Cambodias remote rural “laboratory” workshop in Sompouv Lun we are breaking new ground. Tuber ischii bearing temporary walking aids are made from local materials (sewage tubes and local metals). The prosthesis is fitted immediately after surgery to get the patient up and going – encouraging a body image of two legs, not one. Three weeks after surgery we see the amputee back on his tractor.
The early temporary prosthesis study started in 2006 in cooperation with the Ministry of Social Affairs in Phnom Penh. The study is conducted as a semi-cross over clinical trial with pain and function as main outcome variables.