Limb Loss in Ukraine (2022–2025): Epidemiology, Injury Patterns, and the Role of Protez Hub
Epidemiological Overview
Since 2022, the number of people living with limb loss in Ukraine has increased substantially. According to the Ministry of Health of Ukraine, just over 20,000 new traumatic limb amputations were recorded between 2022 and 2025. This figure includes both war-related and non-war-related cases.
As mortality from exsanguination decreases due to widespread tourniquet use and improved emergency response, the prevalence of survivable but limb-threatening injuries correspondingly rises.
Distribution of Amputation Levels
The most frequently reported amputation level is transtibial (below-the-knee) lower limb amputation, consistent with global trauma epidemiology. This level is generally associated with more favorable functional and prosthetic outcomes compared with transfemoral amputations.
However, healthcare facilities report a higher proportion of transfemoral (above-the-knee) and transhumeral (above-the-elbow) amputations than typically observed in civilian trauma systems. Several contributing factors have been identified:
- Prolonged tourniquet application in battlefield conditions
- Delayed evacuation due to active hostilities
- Extensive soft tissue and vascular destruction from blast injuries
In situations where tourniquet conversion or vascular reconstruction cannot be performed in a timely manner, irreversible ischemia may necessitate higher-level amputation.
Emerging Mechanisms of Injury
The war has introduced injury mechanisms that differ from traditional landmine-dominant trauma patterns. Drone-related explosions and high-energy blast mechanisms are increasingly associated with:
- Complex upper-limb trauma
- Combined blast and penetrating injuries
- Ocular injuries and vision loss
Upper-limb loss presents distinct rehabilitation challenges due to its impact on fine motor function, self-care, communication, and employment. When combined with visual impairment, functional recovery requires integrated rehabilitation strategies and assistive technologies.
Polytrauma and Rehabilitation Complexity
A substantial proportion of individuals with limb loss also present with polytrauma, including:
- Traumatic brain injury
- Hearing or vision impairment
- Spinal or thoracic injury
- Psychological trauma
These cases require coordinated multidisciplinary management involving surgery, prosthetics and orthotics, physical and occupational therapy, neurorehabilitation, and psychosocial support.
Early rehabilitation, structured follow-up, and continuity of prosthetic care are associated with improved functional outcomes and long-term participation.
Rehabilitation System Response
The scale and complexity of limb loss in Ukraine have accelerated reforms in rehabilitation service delivery. Priorities include:
- Standardization of post-amputation rehabilitation protocols
- Workforce development in prosthetics and orthotics
- Expansion of assistive technology access
- Integration of rehabilitation into primary and secondary care pathways
Within this evolving system, non-governmental and professional organizations play a significant supporting role.
The Role of Protez Hub
Protez Hub is an independent Ukrainian initiative established to improve prosthetic and orthotic care, professional education, and system coordination. Its activities focus on capacity building rather than direct clinical service provision.
Key areas of work include:
1. Professional Education
Protez Hub develops and disseminates educational resources for prosthetists, orthotists, rehabilitation physicians, and allied health professionals. This includes structured training programs and continuing professional development opportunities.
Official website:
https://protezhub.com/
2. Knowledge Base (Baza Znan)
The organization maintains an online educational platform offering free courses and reference materials related to limb loss management and rehabilitation.
Knowledge base:
https://bazaznan.protezhub.com/
3. Standards and Policy Support
Protez Hub has initiated and contributed to the development and dissemination of national professional standards and standards for rehabilitation care after limb amputation. These standards aim to harmonize clinical practice and improve outcome consistency across regions.
Information on rehabilitation standards and related publications is available through their website blog and resource sections.
4. Consultation and Navigation Support
Protez Hub provides informational support to individuals seeking guidance on prosthetic services, rehabilitation pathways, and available resources.
Contact information is available at:
https://protezhub.com/en/about-us
Socioeconomic Reintegration
Beyond clinical rehabilitation, long-term outcomes are influenced by accessibility, employment opportunities, and inclusive social policy. Individuals with limb loss — particularly those with combined injuries — may require:
- Workplace adaptation
- Vocational retraining
- Accessible public infrastructure
- Long-term prosthetic maintenance and replacement
Sustainable rehabilitation systems therefore extend beyond acute care and prosthetic fitting to encompass long-term functional participation.
Ukraine has a well-functioning state-funded prosthetics provision program, overseen by the Ministry of Social Policy, Family and Unity.
Official website:
https://protez.msp.gov.ua
Conclusion
Between 2022 and 2025, Ukraine has experienced a marked increase in traumatic limb loss, with just over 20,000 new amputations recorded. Injury patterns include a higher proportion of upper-limb amputations compared with typical civilian trauma populations, as well as a significant burden of polytrauma.
Addressing these needs requires coordinated surgical care, structured rehabilitation, workforce development, and long-term prosthetic support. Organizations such as Protez Hub contribute to this effort through professional education, knowledge dissemination, and standards development, supporting the evolution of Ukraine’s rehabilitation system in response to current demands.