- V. MalykhinaTrauma and Rehabilitation Superhumans Center, Lviv, Ukraine
- D. DmytriievTrauma and Rehabilitation Superhumans Center, Lviv, Ukraine; Vinnytsia National Pirogov Memorial Medical University, Vinnytsia, Ukraine
Background. Chronic pain is a frequent complication after combat-related limb trauma, impairing rehabilitation and quality of life. Globally, chronic pain after severe limb trauma affects roughly half to two-thirds of patients, with phantom limb pain reported in ~ 60–80 % of amputees. Psychosocial factors (e.g., post-traumatic stress disorder (PTSD)) and high acute pain consistently predict persistence, whereas early physiotherapy is generally associated with better outcomes. Evidence specific to Ukrainian military populations remains limited. Materials and methods. We conducted a single-center observational study at the Superhumans Center (Ukraine) from March 2023 to April 2025. A total of 311 Ukrainian military patients with acute limb injuries were followed for six months. Pain intensity was measured with the Numeric Rating Scale (NRS), neuropathic pain features — with DN4, psychological comorbidity — with the Hospital Anxiety and Depression Scale and the PTSD Checklist, functional status — with WHODAS 2.0. Multivariate logistic regression identified predictors of chronic pain at 4–6 weeks. Model discrimination was assessed by the area under the receiver operating characteristic curve. Results. At 4–6 weeks, 168 of 311 patients (54 %) reported chronic pain. Independent predictors included amputation (odds ratio (OR) 2.3, 95% confidence interval (CI) 1.5–3.6), wound infection (OR 2.0, 95% CI 1.2–3.1), prolonged antibiotic therapy > 21 days (OR 1.7, 95% CI 1.1–2.8), baseline NRS ≥ 6 (OR 2.8, 95% CI 1.8–4.2), and PTSD symptoms (OR 2.5, 95% CI 1.5–4.0). Early physiotherapy was protective (OR 0.6, 95% CI 0.4–0.9). Conclusions. More than half of Ukrainian military patients with limb injuries developed chronic pain within six months. Amputation, infection, high baseline pain, PTSD, and prolonged antibiotics were significant risk factors, whereas early physiotherapy mitigated risk. These findings support targeted prevention, vigilant infection control, prudent antibiotic use, and early multidisciplinary rehabilitation pathways in military trauma care.