High-tech prosthetics and rehabilitation of individuals with limb amputations due to combat trauma

Shalygin L.D. ¹, Levchuk A.L.¹, Kovlen D.V.²

Introduction. According to the WHO Disability Report (2011), more than a billion people, or about 15% of the world’s population, live with some form of disability. The proportion of disabled people in Russia is around 7–8% and is expected to increase, especially with the ongoing conflict in Ukraine. By 2023, the total number of disabled people in Russia had reached 10.9 million, with 10.2 million disabled adults.2 Military Medical Academy named after S.M. Kirov, St. Petersburg

According to the WHO (2025), rehabilitation, along with health promotion, disease prevention, treatment, and palliative care, is an integral part of universal health coverage. Currently, an estimated 2.4 billion people worldwide suffer from pathological conditions that may require rehabilitation. Every third person at some point in their life needs rehabilitation due to congenital, acute, or chronic diseases. The need for medical rehabilitation technologies among people with disabilities is 99.8%. Despite the timely and high-quality provision of medical care to the wounded, injured, and sick during combat operations, a number of problems remain unresolved in the medical rehabilitation of disabled people with upper and lower limb amputations due to combat injuries, followed by prosthetics.

The purpose of the clinical lecture is to familiarize a wide range of doctors from various specialties with the old and newly developed rehabilitation routes for military personnel and the high-tech prosthetics used for participants in the special military operation with amputated limbs due to combat injuries.

The main part. The main part of the clinical lecture provides a detailed overview of the concept of high-tech prosthetics and rehabilitation. It describes the algorithm for conducting a prosthetic company, as well as the stages and deadlines for prosthetics in military medical organizations. Special attention is given to quality control in prosthetics. The assessment of the quality of rehabilitation for patients with limb amputations should be conducted comprehensively, taking into account the following key components of quality: structural component, procedural component, and outcome component. The current customer journey of a military personnel with limb amputations from the combat zone to the end of the prosthetics stage is presented in detail. The average prosthetic time is 119-225 days. There is a great need to create a new prosthetics and rehabilitation system for participants in the special military operation, as the current system has a number of drawbacks and problems. A new project has been presented to create a new prosthetics and rehabilitation system for participants in the special military operation, with the goal, objectives, and key provisions outlined. The target customer journey for a soldier with limb amputations in the new prosthetics and rehabilitation system for participants in the special military operation has been described in detail. The average prosthetics time is 65-120 days.

Conclusion. In order to ensure effective prosthetics and rehabilitation under the new system, the Unified Prosthetics Center of the Russian Ministry of Defense (UPC) has been established. The organization of its work has been presented in detail. It should be noted that the UPC is organizationally part of the Unified Center for Coordination of Comprehensive Rehabilitation, Prosthetics, and Support for Military Personnel with Limited Health Opportunities of the Russian Ministry of Defense, while the General Military Medical Directorate of the Russian Ministry of Defense performs a number of tasks to ensure the effective implementation of prosthetics and rehabilitation measures for the successful operation and functioning of the new system of prosthetics and rehabilitation for participants in the Special Military Operation. A universal standard for providing prosthetic services to individuals with limb amputations due to combat injuries has been developed.

1. Order of the Ministry of Labor of the Russian Federation dated 10.04.2025 № 196N “On Approval of the Standard for Providing Services for Social and Psychological Rehabilitation and Adaptation of Disabled Persons Who Have Received Injuries, Wounds, Contusions, or Mutilations in Connection with Military Operations.” (In Russ.)

2. Order of the Ministry of Labor and Social Protection of the Russian Federation № 298n dated May 7, 2025 “On Approval of the Standard for the Provision of Vocational Guidance Services for Persons with Disabilities who have been Injured, Wounded, Concussed, or Maimed in connection with military operations. (In Russ.)

3. Order of the Ministry of Labor of the Russian Federation №302n dated 05.13.2025 “On Approval of the Standard for the provision of social – pedagogical rehabilitation and habilitation of disabled people who have been injured, wounded, concussed, or maimed in connection with military operations.” (In Russ.)

4. Order of the Ministry of Labor and Social Protection of the Russian Federation dated 04/07/2025 № 179n “On Approval of the Standard for the Provision of Services for socio-environmental rehabilitation and Habilitation of Disabled People who have been Injured, Wounded, Concussed, or Maimed in links to the fighting.” (In Russ.)

5. Order №. 141n of the Ministry of Labor and Social Protection of the Russian Federation dated March 24, 2025, “On Approval of the Standard for Providing Social and Domestic Rehabilitation and Ablitation Services for Disabled Persons Who Have Been Injured, Wounded, or Caused Loss of Limb in Combat Operations.” (In Russ.)

6. Order № 381n of the Ministry of Labor and Social Protection of the Russian Federation dated June 18, 2025, “On Approval of the Standard for Providing Hearing Prosthetics to Disabled Persons Who Have Been Injured, Wounded, or Concussed in Combat” (In Russ.)

7. Order of the Ministry of Labor and Social Protection of the Russian Federation dated 18.06.2025 № 380n “On Approval of the Standard for Providing Orthotic Services to Disabled Persons Who Have Been Injured, Wounded, or Concussed in Combat” (In Russ.)

8. Order № 366n of the Ministry of Labor and Social Protection of the Russian Federation dated June 6, 2025, “On Approval of the Standard for Providing Prosthetic Services to Disabled Persons Who Have Been Injured, Wounded, or Contused in Combat” (In Russ.)

9. Order № 92 of the Ministry of Sports of the Russian Federation dated February 7, 2025, “On Approval of Standards for Providing Physical Rehabilitation and Ablitation Services to Persons with Disabilities and Children with Disabilities Using Means and Methods of Adaptive Physical Culture and Adaptive Sports” (In Russ.)