@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(3):175-182
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(3):175-182
Prevalence of Pain in Adolescent Survivors of Landmines and Unexploded Ordnances and its Relationship with Limb Problems
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Poor Zamany Nejat Kermany M. (1)Masoumi M. (*)
Modirian E. (2)
Nouri F. (3)
Khateri Sh. (4)
Shokouhi H. (5)
Soroush M. (4)
Mohsenzadegan A. (4)
(*) Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
(1) Anesthesiology & Critical Care Department, Medicine Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
(2) Emergency Department, Medical Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
(3) Physical Medicine and Rehabilitation Department, Medicine Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
(4) Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
(5) Emergency Medicine Department, Medicine Faculty, George Washington University, Washington DC, the United States
Correspondence
Address: Janbazan Medical and Engineering Research Center (JMERC), No. 17, Farokh Street, Moghadas Ardabili Street, Yaman Street, Shahid Chamran Highway, Tehran, IranPhone: +982122416699
Fax: +982122416699
masoumi48@gmail.com
Article History
Received: January 13, 2015Accepted: February 21, 2015
ePublished: August 25, 2015
ABSTRACT
Aims
Pain and limitation of motion due to amputation of victims, especially children, cause irreversible long-term mobility problems. The aim of this study was to evaluate the prevalence of pain and its relationship with limb problems in adolescent victims of landmines and unexploded ordnances.
Information & Methods In a cross-sectional study in 2009, 76 adolescent victims of landmines and unexploded ordnances (between 6-18 years old) living in five border provinces (West Azerbaijan, Ilam, Kermanshah, Kurdistan & Khuzestan) were evaluated in two heath-recreational camps. Demographic data was collected by questionnaire. The limbs, joint and limb pain were evaluated using physical examinations and history taking by a specialist in physical medicine. The data were analyzed by SPSS 22 software using Chi-square test.
Findings The average age of the victims at the time of the study was 16.11±2.00 years and 65 (85.5%) were male. 23 of the total 41 amputees (56.1%), had upper limb amputations. Pain was reported in all amputees and was significantly higher in lower limbs of 15-18 year old adolescents (p<0.05). Then, contractures (19.7%) and tendinitis and bursitis (18.4%) were the most common complications. Trauma and wounds were the least abundant (2.6%).
Conclusion The most common problem due to amputation in landmines and unexploded ordnances in adolescent victims is pain, particularly back pain and despite of the higher frequency of upper extremity amputations, pain is more prevalent in the lower limb amputees.
Information & Methods In a cross-sectional study in 2009, 76 adolescent victims of landmines and unexploded ordnances (between 6-18 years old) living in five border provinces (West Azerbaijan, Ilam, Kermanshah, Kurdistan & Khuzestan) were evaluated in two heath-recreational camps. Demographic data was collected by questionnaire. The limbs, joint and limb pain were evaluated using physical examinations and history taking by a specialist in physical medicine. The data were analyzed by SPSS 22 software using Chi-square test.
Findings The average age of the victims at the time of the study was 16.11±2.00 years and 65 (85.5%) were male. 23 of the total 41 amputees (56.1%), had upper limb amputations. Pain was reported in all amputees and was significantly higher in lower limbs of 15-18 year old adolescents (p<0.05). Then, contractures (19.7%) and tendinitis and bursitis (18.4%) were the most common complications. Trauma and wounds were the least abundant (2.6%).
Conclusion The most common problem due to amputation in landmines and unexploded ordnances in adolescent victims is pain, particularly back pain and despite of the higher frequency of upper extremity amputations, pain is more prevalent in the lower limb amputees.
CITATION LINKS
[1]Soroush AR, Flahati F, Zargar M, Soroush MR, Araghizadeh H, Khateri Sh, et al. Injuries associated with landmines and unexploded ordnances in Iran. Iran Red Crescent Med J. 2010;12(4):384-7.
[2]Mousavi B, Ganjparvar Z, Soroush M, Khateri S, Shokoohi H, Montazeri A. Life satisfaction in children survivors of landmine and unexploded ordnance. Daneshvar Med. 2013;21(107):15-22. [Persian]
[3]Jahunlu HR, Husum H, Wisborg T. Mortality in land-mine accidents in Iran. Prehospital Disaster Med. 2002;17(2):107-9.
[4]Asadollahi R, Saghafinia M, Nafissi N, Montazeri A, Asadollahi M, Khatami M. Anxiety, depression and health-related quality of life in those injured by landmines, Ilam, Islamic Republic of Iran. East Mediterr Health J. 2010;16(11):1108-14.
[5]Lekfuangfu WN. Mortality risk and human capital investment: the legacy of landmines in Cambodia. Proceedings of the Annual Conference of Royal Economic Society; 2014, 7-9 April. p. 646.
[6]Soroush A, Falahati F, Zargar M, Soroush MR, Khateri S, Khaji A. Amputations Due to Landmine and Unexploded Ordnances in Post-war Iran. Arch Iranian Med. 2008;11(6):595-7.
[7]Kakar F, Bassani F, Romer CJ, Gunn SW. The consequence of land mines on public health. Prehosp Disaster Med. 1996;11(1):2-10.
[8]Authors not released. Landmine-related injuries, 1993-1996. Morbid Mortal Week Rep. 1997;46(31):724-6.
[9]Walsh NE, Walsh WS. Rehabilitation of landmine victims--the ultimate challenge. Bull World Health Organ. 2003;81(9):665-70.
[10]Durham J, Hill PS, Hoy D. The underreporting of landmine and explosive remnants of war injuries in the Cambodia, the lao people’s democratic republic and Viet Nam. Bull World Health Orga. 2013;91:234-6.
[11]Ganjparvar Z, Mousavi B, Soroush M, Shokoohi H, Khateri S, Montazeri A. Quality of life among children survivors of land mine and explosive remnants of war. Daneshvar Med. 2012;19(96):11-8.
[12]Mousavi B, Soroush MR, Masoumi M, Khateri S, Modirian E, Shokoohi H, et al. Epidemiological study of child casualties of landmines and unexploded ordnances: A national study from Iran. Prehosp Disaster Med. 2015;30(5):472-7.
[13]Kinra S, Black ME. Landmine related injuries in children of Bosnia and Herzegovina 1991–2000: comparisons with adults. J Epidemio Community Health. 2003;57(4):264-5.
[14]Hussein EMA, Waller EK. Landmine detection: The problem and the challenge. Appl Radiation Isotopes. 2000;53(4-5):557-63.
[15]Falahati F, Soroush M, Khateri S. The impacts of landmine and the explosive remnants of war–induced injuries on the survivor’s quality of life. 1st edition. Tehran: Janbazan Medical and Engineering Research Center (JMERC); 2010. P. 40.
[16]Boyce W. Adaptation of community based rehabilitation in areas of armed conflict. Asia Paci Disabil Rehabil J. 2000;11(1):1-12.
[17]Andersson N, da Sousa CP, Paredes S. Social cost of land mines in four countries: Afghanistan, Bosnia, Cambodia, and Mozambique. BMJ. 1995;16(311):718-21.
[18]Barbir A. Validation of lower limb surrogates as injury assessment tools in floor impacts due to antivehicular landmine explosions [Dissertation]. Wayne State University Theses; 2005. P. 287.
[19]Shahriar Sh. Health and rehabilitation /guideline in lower limb amputation. 1st edition. Tehran: Janbazan Medical and Engineering Research Center (JMERC); 2009. p.p. 39-68. [Persian]
[20]Yavari A, Esfandiari E, Masoumi M, Saeedi H, Allami M. Consideration of chronic pain and current prosthetic satisfaction in above knee amputees. Iran J War Public Health. 2011;3(2):53-8.
[21]Rahimi A, Masoumi M, Soroush M, Mousavi B. Orthopaedic Complications in Bilateral Lower Limb Amputation. Iran J Ortop. 2009;7(2):58-63.
[22]Bilukha OO, Brennan M, Anderson M, Tsitsaev Z, Murtazaeva E, Ibragimov R. Seen but not heard: injuries and deaths from landmines and unexploded ordnance in Chechnya. Prehosp Disaster Med. 2007;22(6):507-12.
[23]Can M, Yildirimcan H, Ozkalipci O, Melek M, Edirne Y, Bicer U, Uner HB. Landmine associated injuries in children in Turkey. J Forensic Leg Med. 2009;16(8):464-8.
[24]Surrency AB, Graitcer PL, Henderson AK. Key factors for civilian injuries and deaths from exploding landmines and ordnance. Inj Prev. 2007;13(3):197-201.
[25]Bendinelli C. Effects of land mines and unexploded ordnance on the pediatric population and comparison with adults in rural Cambodia. World J Surg. 2009;33(5):1070-4.
[26]Shabila NP, Taha HI, Al-Hadithi TS. Landmine injuries at the emergency management center in Erbil, Iraq. Confl Health. 2010;4:15.
[27]Dougherty PJ. Long-term follow up of unilateral above knee amputees. J Orthop Trauma. 2000;14(2):140.
[28]Daniel L. Gatt, Charalambos P.C. Ultrasound-guided barbotage for calcific tendonitis of the shoulder: A systematic review including 908 patients. Arthrosc J Arthrosc Relat Surg. 2014;30(9):1166-72.
[29]Sehirlioglu A, Ozturk C, Yazicioglu K, Tugcu I, Yilmaz B, Goktepe AS. Painful neuroma requiring surgical excision after lower limb amputation caused by landmine explosions. Int Orthop. 2009;33(2):533-6.
[30]Atesalp AS, Erler K, Gür E, Köseğlu E, Kirdemir V, Demiralp B. Bilateral lower limb amputations as a result of landmine injuries. Prosthet Orthot Int. 1999;23(1):50-4.
[31]Ebrahimzadeh MH, Fattahi SA, Nejhad AB. Long-term follow-up of Iranian veteran upper extremity amputees from the Iran-Iraq war (1980-1988). J Traume. 2006;61(4):886-8.
[2]Mousavi B, Ganjparvar Z, Soroush M, Khateri S, Shokoohi H, Montazeri A. Life satisfaction in children survivors of landmine and unexploded ordnance. Daneshvar Med. 2013;21(107):15-22. [Persian]
[3]Jahunlu HR, Husum H, Wisborg T. Mortality in land-mine accidents in Iran. Prehospital Disaster Med. 2002;17(2):107-9.
[4]Asadollahi R, Saghafinia M, Nafissi N, Montazeri A, Asadollahi M, Khatami M. Anxiety, depression and health-related quality of life in those injured by landmines, Ilam, Islamic Republic of Iran. East Mediterr Health J. 2010;16(11):1108-14.
[5]Lekfuangfu WN. Mortality risk and human capital investment: the legacy of landmines in Cambodia. Proceedings of the Annual Conference of Royal Economic Society; 2014, 7-9 April. p. 646.
[6]Soroush A, Falahati F, Zargar M, Soroush MR, Khateri S, Khaji A. Amputations Due to Landmine and Unexploded Ordnances in Post-war Iran. Arch Iranian Med. 2008;11(6):595-7.
[7]Kakar F, Bassani F, Romer CJ, Gunn SW. The consequence of land mines on public health. Prehosp Disaster Med. 1996;11(1):2-10.
[8]Authors not released. Landmine-related injuries, 1993-1996. Morbid Mortal Week Rep. 1997;46(31):724-6.
[9]Walsh NE, Walsh WS. Rehabilitation of landmine victims--the ultimate challenge. Bull World Health Organ. 2003;81(9):665-70.
[10]Durham J, Hill PS, Hoy D. The underreporting of landmine and explosive remnants of war injuries in the Cambodia, the lao people’s democratic republic and Viet Nam. Bull World Health Orga. 2013;91:234-6.
[11]Ganjparvar Z, Mousavi B, Soroush M, Shokoohi H, Khateri S, Montazeri A. Quality of life among children survivors of land mine and explosive remnants of war. Daneshvar Med. 2012;19(96):11-8.
[12]Mousavi B, Soroush MR, Masoumi M, Khateri S, Modirian E, Shokoohi H, et al. Epidemiological study of child casualties of landmines and unexploded ordnances: A national study from Iran. Prehosp Disaster Med. 2015;30(5):472-7.
[13]Kinra S, Black ME. Landmine related injuries in children of Bosnia and Herzegovina 1991–2000: comparisons with adults. J Epidemio Community Health. 2003;57(4):264-5.
[14]Hussein EMA, Waller EK. Landmine detection: The problem and the challenge. Appl Radiation Isotopes. 2000;53(4-5):557-63.
[15]Falahati F, Soroush M, Khateri S. The impacts of landmine and the explosive remnants of war–induced injuries on the survivor’s quality of life. 1st edition. Tehran: Janbazan Medical and Engineering Research Center (JMERC); 2010. P. 40.
[16]Boyce W. Adaptation of community based rehabilitation in areas of armed conflict. Asia Paci Disabil Rehabil J. 2000;11(1):1-12.
[17]Andersson N, da Sousa CP, Paredes S. Social cost of land mines in four countries: Afghanistan, Bosnia, Cambodia, and Mozambique. BMJ. 1995;16(311):718-21.
[18]Barbir A. Validation of lower limb surrogates as injury assessment tools in floor impacts due to antivehicular landmine explosions [Dissertation]. Wayne State University Theses; 2005. P. 287.
[19]Shahriar Sh. Health and rehabilitation /guideline in lower limb amputation. 1st edition. Tehran: Janbazan Medical and Engineering Research Center (JMERC); 2009. p.p. 39-68. [Persian]
[20]Yavari A, Esfandiari E, Masoumi M, Saeedi H, Allami M. Consideration of chronic pain and current prosthetic satisfaction in above knee amputees. Iran J War Public Health. 2011;3(2):53-8.
[21]Rahimi A, Masoumi M, Soroush M, Mousavi B. Orthopaedic Complications in Bilateral Lower Limb Amputation. Iran J Ortop. 2009;7(2):58-63.
[22]Bilukha OO, Brennan M, Anderson M, Tsitsaev Z, Murtazaeva E, Ibragimov R. Seen but not heard: injuries and deaths from landmines and unexploded ordnance in Chechnya. Prehosp Disaster Med. 2007;22(6):507-12.
[23]Can M, Yildirimcan H, Ozkalipci O, Melek M, Edirne Y, Bicer U, Uner HB. Landmine associated injuries in children in Turkey. J Forensic Leg Med. 2009;16(8):464-8.
[24]Surrency AB, Graitcer PL, Henderson AK. Key factors for civilian injuries and deaths from exploding landmines and ordnance. Inj Prev. 2007;13(3):197-201.
[25]Bendinelli C. Effects of land mines and unexploded ordnance on the pediatric population and comparison with adults in rural Cambodia. World J Surg. 2009;33(5):1070-4.
[26]Shabila NP, Taha HI, Al-Hadithi TS. Landmine injuries at the emergency management center in Erbil, Iraq. Confl Health. 2010;4:15.
[27]Dougherty PJ. Long-term follow up of unilateral above knee amputees. J Orthop Trauma. 2000;14(2):140.
[28]Daniel L. Gatt, Charalambos P.C. Ultrasound-guided barbotage for calcific tendonitis of the shoulder: A systematic review including 908 patients. Arthrosc J Arthrosc Relat Surg. 2014;30(9):1166-72.
[29]Sehirlioglu A, Ozturk C, Yazicioglu K, Tugcu I, Yilmaz B, Goktepe AS. Painful neuroma requiring surgical excision after lower limb amputation caused by landmine explosions. Int Orthop. 2009;33(2):533-6.
[30]Atesalp AS, Erler K, Gür E, Köseğlu E, Kirdemir V, Demiralp B. Bilateral lower limb amputations as a result of landmine injuries. Prosthet Orthot Int. 1999;23(1):50-4.
[31]Ebrahimzadeh MH, Fattahi SA, Nejhad AB. Long-term follow-up of Iranian veteran upper extremity amputees from the Iran-Iraq war (1980-1988). J Traume. 2006;61(4):886-8.