RESEARCH PAPER
Bone stump formation against the background of post-amputation pain syndrome
 
More details
Hide details
1
Scientific Department, Research Institute of Rehabilitation of National Pirogov Memorial Medical University, Vinnytsia, Ukraine
CORRESPONDING AUTHOR
Yurii Oleksiiovych Bezsmertnyi   

104, Khmelnytsky highway, Vinnytsia, 21029, Ukraine.
Submission date: 2021-07-23
Final revision date: 2021-09-15
Acceptance date: 2021-09-15
Online publication date: 2021-09-27
 
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Bone is the basis of the stump.

Aim:
To study the impact of post-amputation pain syndrome on the nature of reparative processes in the bone residual limb.

Material and methods:
Three series of experiments were performed on 45 rabbits, 15 in each with mid-third thigh amputation and muscular plasty. In series 1, 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 lidocaine (1%) was injected through the catheter into the circumference of the nerve twice daily for 20 days. Series 3 is 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 and discussion:
In series 1, there was a sharp disturbance of the reparative process, which consisted in shape changes, resorption of the cortical diaphyseal plate, fractures, stump deformity, absence of bone closure plate formation, and microcirculatory disturbances. In the overall majority of experiments of series 2, the stumps retained the shape and structure characteristic of diaphysis with normalization of microcirculation. In series 3, the results of the residual limb formation were better than in series1, but worse than in series 2.

Conclusions:
When the pain syndrome is resolved within 20 days after amputation, a bone stump is formed with an organotypic shape and structure characteristic of the diaphysis, the formation of a compact closure plate of mature bone tissue, normalization of the medullary tissues and blood circulation. In post-amputation pain syndrome, organotypic formation of the residual limb does not occur.

FUNDING
The study was conducted within the framework of the research work «Revealing regularities in the formation of post-amputation pain syndrome», funded by the Ministry of Health of Ukraine with the state budget (No 0120U101372).
CONFLICT OF INTEREST
None declared.
 
REFERENCES (13)
1.
Ahmed A, Bhatnagar S, Mishra S, Khurana D, Joshi S, Ahmad SM. Prevalence of Phantom Limb Pain, Stump Pain, and Phantom Limb Sensation among the Amputated Cancer Patients in India: A Prospective, Observational Study. Indian J Palliat Care. 2017;23(1):24–35. https://doi.org/10.4103/0973-1....
 
2.
Ahuja V, Thapa D, Ghai B. Strategies for prevention of lower limb post-amputation pain: A clinical narrative review. J Anaesthesiol Clin Pharmacol. 2018;34(4):439–449. https://doi.org/10.4103/joacp.....
 
3.
Allami M, Faraji E, Mohammadzadeh F, Soroush MR. Chronic musculoskeletal pain, phantom sensation, phantom and stump pain in veterans with unilateral below-knee amputation. Scand J Pain. 2019;19(4):779–787. https://doi.org/10.1515/sjpain....
 
4.
Shevchuk VI, Bezsmertnyi YO, BezsmertnaGV, Dovgalyuk TV, JiangY. Peculiar features of regeneration at the end of bone filing after amputation of a limb. World Med Biol. 2021;1(75):229–234. https://doi.org/10.26724/2079-....
 
5.
Shevchuk VI, Bezsmertnyi YO, Bezsmertna HV, Dovgalyuk TV, Jiang Y. Reparative regeneration at the end of bone filing after ostoplastic amputation. Wiad Lek. 2021;74(3p1):413–417. https://doi.org/10.36740/WLek2....
 
6.
Bosanquet DC, Glasbey JC, Stimpson A, Williams IM, Twina CP. Systematic review and meta-analysis of the efficacy of perineural local anaesthetic catheters after major lower limb amputation. Eur J Vasc Endovasc Surg. 2015;50(2):241–249. https://doi.org/10.1016/j.ejvs....
 
7.
Buch NS, Qerama E, Brix Finnerup N, Nikolajsen L. Neuromas and postamputation pain. Pain. 2020;161(1):147–155. https://doi.org/10.1097/j.pain....
 
8.
Buntragulpoontawee M, Pattamapaspong N, Tongprasert S. Multiple Neuromas Cause Painful ‘Jumping Stump’ in a Transfemoral Amputee: A Case Report. Int J Low Extrem Wounds. 2016;15(3):271–273. https://doi.org/10.1177/153473....
 
9.
Buchheit T, Hsia HJ, Cooter M, et al. 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 Med. 2019;20(10):2004–2017. https://doi.org/10.1093/pm/pnz....
 
10.
Dumanian GA, PotterBK, Mioton LM, et al. Targeted Muscle Reinnervation Treats Neuroma and Phantom Pain in Major Limb Amputees: A Randomized Clinical Trial. Ann Surg. 2019;70(2):238–246. https://doi.org/10.1097/SLA.00....
 
11.
Gilmore C, Ilfeld B, Rosenow J, et al. Percutaneous peripheral nerve stimulation for the treatment of chronic neuropathic postamputation pain: a multicenter, randomized, placebo-controlled trial. Reg Anesth Pain Med. 2019;44(6):637–645. https://doi.org/10.1136/rapm-2....
 
12.
Grjibovski AM, Ivanov SV, Gorbatova MA. Descriptive statistics using Statistica and SPSS software. Nauka Zdravookhranenie [Science&Healthcare]. 2016;(1):7–23.
 
13.
Grjibovski AM, Ivanov SV, Gorbatova MA. Analysis of quantitative data in two independent samples using Statistica and SPSS software: parametric and non-parametric tests. Nauka Zdravookhranenie [Science&Healthcare]. 2016;(2):5–28.