Long-term outcomes after intrepid dynamic exoskeletal orthosis treatment coupled with advanced rehabilitation

Objective: To measure Intrepid Dynamic Exoskeletal Orthosis (IDEO) use patterns, return to work or return to duty, and amputation rate among patients undergoing limb salvage ≥2 years after discharge. Design: Telephone survey and retrospective medical chart review. Setting: Military tertiary care hospital and rehabilitation center. Patients/Participants: A total of 190 active duty or retired service members, military health care beneficiaries, and civilians aged 22 to 64 years old with traumatic lower limb injuries treated with an IDEO were invited to participate in a telephone survey. A total of 145 individuals (76.3% of those contacted) completed the survey. Main Outcome Measurements: IDEO use patterns, participation in the Return to Run (RTR) rehabilitation program, return to work or active duty, and elective amputation rate. Results: The most common initial diagnosis was lower limb fracture (54.5% of participants). The most common mechanism of injury was from explosive devices (22.8%). After IDEO prescription, 86.9% of respondents participated in the RTR program. Approximately 77.9% of patients returned to work; 67.3% of active duty IDEO users returned to active duty. At final follow-up (mean 90.3 ± 32.9 months, range 24.0-157.0 months), 80 patients (55.2%) still use their IDEO, whereas 14 patients (9.7%) had elected for amputation. Conclusions: Long-term IDEO use combined with the RTR rehabilitation program was associated with positive long-term outcomes as evidenced by a high self-reported activity level, high rate of return to work or duty, and low elective amputation rate among patients with severe lower limb injuries.