Sunday, February 12, 2006

Healing,

with new limbs.

Explosions have killed 1,123 American service members in Iraq and have wounded at least 10 times more, often with a devastating combination of injuries — ruptured organs and severed spines, obliterated limbs and burst eyeballs.

Among the more than 16,653 Americans wounded in Iraq are 387 amputees, including 62 who, like Corporal Beyers, have lost more than one limb, said Lt. Col. Paul Pasquina, chief of physical medicine and rehabilitation at Walter Reed. The amputations, traumatic though they are, are often accompanied by painful complications. "It's not as easy as putting on even the most high-tech prosthetic and just walking off," Colonel Pasquina said.

Most of the amputees returning from combat zones have an infection, because a bomb blast can embed bacteria, dirt or pieces of clothing deep into the wound, Colonel Pasquina said. A severe infection could require further amputation or possibly be fatal.

About 20 percent of the amputees have had potentially serious blood clots that formed as a result of the initial trauma. About half of them experience a condition in which bone grows at the site of amputation, called heterotopic ossification, he said. In the worst cases, the growth can prevent proper fitting of a prosthesis or pierce the skin.

Corporals Schilling and Beyers each have mild cases of abnormal bone growth. Fissures also have formed at the end of their stumps, where their wounds were closed, and the irritated, blistered skin could become infected.

Artificial limbs are increasingly sophisticated — legs with microprocessors that help provide stability and a normal gait, or arms with attachments shaped to catch baseballs or flip pancakes. But the psychological effects of losing a limb, particularly for young, active military members, can be deep and lasting, a constant reminder of the war.

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