Peculiar Features of Regeneration at the End of Bone Filing After Amputation of a Limb

Шевчук, В. І.; Bezsmertnyi, Yu. O.; Bezsmertna, G. V.; Dovgalyuk, T. V.; Jiang, Yankai

doi:10.26724/2079-8334-2021-1-75-229-234

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Особливо це стосується кістяка кукси -її кісткової основи. Незважаючи на велику кількість праць, у яких мова йде про ампутації і післяампутаційний больовий синдром, хвороби і вади кукс [1][2][3][4][5][6][7][8], лише поодинокі повідомлення [9,10] висвітлюють процеси репаративної регенерації на кінці кісткового фрагмента. Залишаються невивченими питання формоутворення кінця кукси кістки в разі супутнього післяампутаційного больового синдрому.…”

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The influence of post-amputation pain syndrome and intraosseous main vessels on the formation of limb bone stump

Bezsmertnyi¹,

Шевчук²,

Jiang³

2022

OTP

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Until now, remains quit high a percentage of unsatisfactory results of amputations. At the same time, a special place is occupiedby the healing of the bone remnant — the main supporting element of the stump. Objective. To study the influence of post-amputationpain syndrome and intraosseous main vessels on the nature of reparative processes in the bone stump. Methods. Three series of 15 experimentswere conducted on 45 rabbits with amputation of the femur in the middle third and muscle plastic surgery. In the 1st and2nd series, d uring a mputation, a p erineural c atheter w as b rought to the stumps of the sciatic nerve. With its help, animals were subjectedto the following daily for 20 days: 1st series — mechanical irritation of the nerve, 20 minutes; 2nd — injection of 0.3 ml of 1 %lidocaine twice a day into the surrounding area of the nerve. Animals of the 3rd series were the control. In 1, 3, 6 months. a histologicalexamination was performed with the pouring of carcass (gelatin mixture) into the vessels. The results. In the 1st series, there was a sharpviolation of the reparative process: a change in the shape and loosening of the cortical diaphyseal plate, fractures and deformationof the stump, a significant expansion of the feeding artery and its branches with perforation of the endosteal regenerate, the absenceof formation of the bone closing plate, a violation of the microcirculation. In the animals of the 2nd series, the stumps mostly kept the shapeand structure characteristic of the diaphysis with normalization of macro- and microcirculation. In the 3rd series, the results of stumpformation were better than in the 1st, but worse than in the 2nd. Conclusions. If the pain syndrome subsides after amputation, a bonestump is formed with an organotypic shape and structure characteristic of the diaphysis, normalization of the state of bone marrowtissues and blood circulation. The rapid and complete formation of the bone closing plate contributes to the reduction of the branchesof the feeding artery and prevents the functional depressurization of the bone marrow cavity. In the presence of post-amputation painsyndrome, there are significant violations of the reparative process with the formation of an inferior bone closing plate, its penetrationby the branches of the feeding artery without the organotypic formation of the stump.

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Section: вCтупunclassified

The influence of post-amputation pain syndrome and intraosseous main vessels on the formation of limb bone stump

Bezsmertnyi¹,

Шевчук²,

Jiang³

2022

OTP

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“…MORPHOLOGIA • 2021 • Том 15 • № 3 51 ва культи -ее костной основы. Несмотря на большое количество работ, посвященных ампутациям и послеампутационному болевому синдрому, болезням и порокам культей [1][2][3][4][5][6][7][8], имеются лишь единичные сообщения [9,10], которые освещают процессы репаративной регенерации на конце костного остатка будущего рабочего органа. Остаются неизученными вопросы формообразования конца культи кости при сопутствующем послеампутационном болевом синдроме.…”

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Impact of post- amputation pain syndrome on the results of bone stump formation

Bezsmertnyi¹,

Шевчук²,

Jiang³

et al. 2021

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Background. To the present day, a high rate of unsatisfactory amputation results still exists. The healing of the bone residual limb, the main support element of the residual limb, is of particular importance. Objective. To study the impact of postamputation pain syndrome on the nature of reparative processes in the bone residual limb. Methods. Three series of experiments were performed on 45 rabbits, 15 in each with mid-third thigh amputation and muscular plasty. In series 1 and 2, a perineural catheter was attached to the sciatic nerve stump during amputation, and mechanical irritation of the nerve was performed daily for 20 minutes in series 1 for 20 days. In series 2, 0.3 ml of 1% lidocaine was injected through the catheter into the circumference of the nerve twice daily for 20 days. Animals of series 3 served as a control. The follow-up periods were 1, 3, 6 months. The study method was histological with infusion of the vessels with ink-gelatin mixture. Results. In series 1, there was a sharp disturbance of the reparative process, which consisted in shape changes, resorption of the cortical diaphyseal plate, stump deformity, absence of bone closure plate formation, and microcirculatory disturbances. In most experiments of the 2nd series, organotypic stumps were formed with normalized microcirculation. In series 3, the results of the residual limb formation were better than in series 1, but worse than in series 2. Conclusion. In the absence of pain syndrome, the bone stump after amputation at the diaphysis level over a period of 1, 3, 6 months retains its cylindrical shape, the structure of the cortical diaphyseal plate, the content of the medullary canal with normal microcirculation, the formation of the bone closure plate, and the completion of the reparative process. The presence of postamputation pain syndrome in the stump distorts the course of the reparative process with the development of pathological remodeling of bone tissue.

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“…Especially it concerns the backbone of a residual limb -its bone base. Despite a large number of studies on amputations and post-amputation pain syndrome, diseases, and defects of stumps [1][2][3][4][5][6][7][8], there are only a few reports [9,10] that highlight reparative regeneration processes at the end of the bone remnant of the future working organ. The blood circulation of the bone residual limb in concomitant postamputation pain syndrome remains unexplored, which is observed in 44.6-90 % of cases [11].…”

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confidence: 99%

Influence of post-amputation pain syndrome on blood circulation in the bone residual limb

Shevchuk,

Bezsmertnyi,

Jiang

et al. 2023

PJS

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Background. The percentage of unsatisfactory amputation results is still high. The healing of the bone remnant, the main supporting element of the residual limb, is of particular importance. The purpose was to study the effect of post-amputation pain syndrome on the nature of blood circulation in the bone residual limb. Materials and methods. Three series of experiments with amputation of the thigh were conducted on 54 rabbits. In the series 1 and 2, a perineural catheter was brought to the stump of the sciatic nerve. In series 1, for 20 days, every day for 20 minutes, mechanical irritation of the nerve was done, causing a pain syndrome using the perineural catheter. In series 2, 0.3 ml of 1% lidocaine was injected twice daily for 20 days; series 3 was a control. The follow-up periods were 1, 3, and 6 months. The study method was histological with the infusion of vessels with an ink-gelatin mixture. Results. Animals of the first series developed avascularity of the end of the stump and bone marrow, poor vascularity and absence of cellular composition in the Haversian canals, dystrophic changes in adipose bone marrow, rarefication, spongiosis, resorption, and bone fractures. In series 2, the avascularity passed quickly and by three months, the angioarchitectonics was stabilized. Revascularization of the bone stump occurs due to the preserved sources of blood circulation (intramedullary vascular network, periosteum and surrounding soft tissues) anastomosing vessels and extravascular pathways of microcirculation (increased vascular permeability, formation of sinusoidal capillaries and tissue cysts). In most observations of series 3, the processes of revascularization were similar to the results of the 1st series. Conclusions. Postamputation pain syndrome causes abrupt macro- and microcirculatory disturbances. Pain syndrome suppression allows to considerably level the arising circulatory disorders in the bone residual limb.

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Peculiar Features of Regeneration at the End of Bone Filing After Amputation of a Limb

Cited by 4 publications

References 8 publications

The influence of post-amputation pain syndrome and intraosseous main vessels on the formation of limb bone stump

The influence of post-amputation pain syndrome and intraosseous main vessels on the formation of limb bone stump

Impact of post- amputation pain syndrome on the results of bone stump formation

Influence of post-amputation pain syndrome on blood circulation in the bone residual limb

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