“An interval of comfort”: postamputation pain & long-term consequences of amputation in British First World War veterans, 1914-1985
File(s)
Author(s)
Dixon Smith, Sarah Louise
Type
Thesis
Abstract
The First World War resulted in the largest amputee cohort in history, with 41,208 amputees in the UK alone; the majority injured as young men and surviving into the late 20th century. Recent studies have estimated that significant residual limb pain affects up to 85% of military amputees: applying this figure to the First World War amputee cohort raises the possibility that up to 35,000 British veterans may have experienced chronic postamputation pain. Despite this and the fact that 13% of injuries in this conflict resulted in amputation, there has been little research into the long-term impact on veterans’ health and quality of life.
Recently catalogued historical medical and pension files held at The National Archives offer the opportunity to follow up this type of injury in a large group of veterans for the first time. This thesis will use these files to document and explore long-term outcomes of amputation and chronic postamputation pain, developments made in the treatment of this condition, the impact of aging on amputee veterans and their likelihood of developing a concomitant condition from 1914 to 1985. It will examine these issues from three perspectives: that of the injured servicemen, the civil servants attempting to value and compensate those injuries, and from the clinicians’ responsible for the veterans’ medical care and rehabilitation. This research has been based on a unique model of interdisciplinary collaboration, incorporating research methods from history and clinical medicine, and will present its findings from historical material with recommendations for current practice.
Given the similarities in injury patterns and prevalence of chronic residual limb, phantom and neuropathic pain between the First World War cohort and contemporary casualties, it is anticipated that the findings of the project will assist in the strategic assessment and planning for long-term pain conditions by medical staff and care providers for today’s and future blast injury amputee cohorts.
Recently catalogued historical medical and pension files held at The National Archives offer the opportunity to follow up this type of injury in a large group of veterans for the first time. This thesis will use these files to document and explore long-term outcomes of amputation and chronic postamputation pain, developments made in the treatment of this condition, the impact of aging on amputee veterans and their likelihood of developing a concomitant condition from 1914 to 1985. It will examine these issues from three perspectives: that of the injured servicemen, the civil servants attempting to value and compensate those injuries, and from the clinicians’ responsible for the veterans’ medical care and rehabilitation. This research has been based on a unique model of interdisciplinary collaboration, incorporating research methods from history and clinical medicine, and will present its findings from historical material with recommendations for current practice.
Given the similarities in injury patterns and prevalence of chronic residual limb, phantom and neuropathic pain between the First World War cohort and contemporary casualties, it is anticipated that the findings of the project will assist in the strategic assessment and planning for long-term pain conditions by medical staff and care providers for today’s and future blast injury amputee cohorts.
Version
Open Access
Date Issued
2022-09
Date Awarded
2023-03
Copyright Statement
Creative Commons Attribution NonCommercial NoDerivatives Licence
Advisor
Rice, Andrew SC
Mayhew, Emily
Hay, George
Sponsor
The Royal British Legion
Publisher Department
Surgery & Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)