The influence of post-amputation pain syndrome and intraosseous main vessels on the formation of limb bone stump
DOI:
https://doi.org/10.15674/0030-598720221-220-25Keywords:
Amputation, pain syndrome, neuritis, reparative regeneration, feeding arteryAbstract
Until now, remains quit high a percentage of unsatisfactory results of amputations. At the same time, a special place is occupied
by the healing of the bone remnant — the main supporting element of the stump. Objective. To study the influence of post-amputation
pain syndrome and intraosseous main vessels on the nature of reparative processes in the bone stump. Methods. Three series of 15 experiments
were conducted on 45 rabbits with amputation of the femur in the middle third and muscle plastic surgery. In the 1st and
2nd 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 subjected
to 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 histological
examination was performed with the pouring of carcass (gelatin mixture) into the vessels. The results. In the 1st series, there was a sharp
violation of the reparative process: a change in the shape and loosening of the cortical diaphyseal plate, fractures and deformation
of the stump, a significant expansion of the feeding artery and its branches with perforation of the endosteal regenerate, the absence
of formation of the bone closing plate, a violation of the microcirculation. In the animals of the 2nd series, the stumps mostly kept the shape
and structure characteristic of the diaphysis with normalization of macro- and microcirculation. In the 3rd series, the results of stump
formation were better than in the 1st, but worse than in the 2nd. Conclusions. If the pain syndrome subsides after amputation, a bone
stump is formed with an organotypic shape and structure characteristic of the diaphysis, normalization of the state of bone marrow
tissues and blood circulation. The rapid and complete formation of the bone closing plate contributes to the reduction of the branches
of the feeding artery and prevents the functional depressurization of the bone marrow cavity. In the presence of post-amputation pain
syndrome, there are significant violations of the reparative process with the formation of an inferior bone closing plate, its penetration
by the branches of the feeding artery without the organotypic formation of the stump.
References
- Bhatnagar, S., Ahmed, A., Mishra, S., Khurana, D., Joshi, S., & Ahmad, S. (2017). Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: A prospective, observational study. Indian Journal of Palliative Care, 23 (1), 24-35. doi:10.4103/0973-1075.197944
- Ghai, B., Ahuja, V., & Thapa, D. (2018). Strategies for prevention of lower limb post-amputation pain: A clinical narrative review. Journal of Anaesthesiology Clinical Pharmacology, 34 (4), 439. doi:10.4103/joacp.joacp_126_17
- Allami, M., Faraji, E., Mohammadzadeh, F., & Soroush, M. R. (2019). Chronic musculoskeletal pain, phantom sensation, phantom and stump pain in veterans with unilateral below-knee amputation. Scandinavian Journal of Pain, 19 (4), 779-787. doi:10.1515/sjpain-2019-0045
- Shevchuk, V. I., Bezsmertnyi, Y. O., Bezsmertna, G. V., Dovgalyuk, T. V., & Jiang, Y. (2021). Peculiar features of regeneration at the end of bone filing after amputation of a limb. World of Medicine and Biology, 17 (75), 229. doi:10.26724/2079-8334-2021-1-75-229-234
- Shevchuk, V. I., Bezsmertnyi, Y. O., Bezsmertna, H. V., Dovgalyuk, T. V., & Jiang, Y. (2021). Reparative regeneration at the end of bone filing after ostoplastic amputation. Wiadomości Lekarskie, 74 (3), 413–417. doi:10.36740/wlek202103106
- Bosanquet, D., Glasbey, J., Stimpson, A., Williams, I., & Twine, C. (2015). Systematic review and meta-analysis of the efficacy of perineural local anaesthetic catheters after major lower limb amputation. European Journal of Vascular and Endovascular Surgery, 50 (2), 241-249. doi:10.1016/j.ejvs.2015.04.030
- Buch, N. S., Qerama, E., Brix Finnerup, N., & Nikolajsen, L. (2019). Neuromas and postamputation pain. Pain, 161 (1), 147-155. doi:10.1097/j.pain.0000000000001705
- Buntragulpoontawee, M., Pattamapaspong, N., & Tongprasert, S. (2016). Multiple neuromas cause painful «Jumping stump» in a Transfemoral amputee. The International Journal of Lower Extremity Wounds, 15 (3), 271–273. doi:10.1177/1534734616657964
- Buchheit, T., Hsia, H. J., Cooter, M., Shortell, C., Kent, M., McDuffie, M., … Van de Ven, T. (2019). The impact of surgical amputation and Valproic acid on pain and functional trajectory: Results from the veterans integrated pain evaluation research (VIPER) randomized, double-blinded placebo-controlled trial. Pain Medicine, 20(10), 2004-2017. doi:10.1093/pm/pnz067
- Dumanian, G. A., Potter, B. K., Mioton, L. M., Ko, J. H., Cheesborough, J. E., Souza, J. M., … Jordan, S. W. (2019). Targeted muscle Reinnervation treats neuroma and phantom pain in major limb amputees. Annals of Surgery, 270 (2), 238-246. doi:10.1097/sla.0000000000003088
- Gilmore, C., Ilfeld, B., Rosenow, J., Li, S., Desai, M., Hunter, C., … Boggs, J. (2019). Percutaneous peripheral nerve stimulation for the treatment of chronic neuropathic postamputation pain: A multicenter, randomized, placebo-controlled trial. Regional Anesthesia & Pain Medicine, 44 (6), 637-645. doi:10.1136/rapm-2018-100109
- Filipowska, J., Tomaszewski, K. A., Niedźwiedzki, Ł., Walocha, J. A., & Niedźwiedzki, T. (2017). The role of vasculature in bone development, regeneration and proper systemic functioning. Angiogenesis, 20 (3), 291-302. doi:10.1007/s10456-017-9541-1
- Beverly, M., & Murray, D. (2018). Factors affecting intraosseous pressure measurement. Journal of Orthopaedic Surgery and Research, 13 (1). doi:10.1186/s13018-018-0877-z
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