RESEARCH PAPER
Changes in the structural organization of bone after amputation
 
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1
Scientific Department, Research Institute of Rehabilitation of National Pirogov Memorial Medical University, Vinnytsya, Ukraine
2
Department of Orthopedics and Traumatology, The second hospital of Shandong University, Shandong, China
CORRESPONDING AUTHOR
Yurii Oleksiiovych Bezsmertnyi   

Scientific Department, Research Institute of Rehabilitation of National Pirogov Memorial Medical University, 104, Khmelnytsky highway, Vinnytsya, Ukraine, 21029.
Submission date: 2020-05-12
Final revision date: 2020-07-28
Acceptance date: 2020-07-28
Online publication date: 2020-09-11
 
Pol. Ann. Med. 2020;27(2):147–153
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Despite a considerable amount of work on limb amputations, questions of the mechanism and conditions for the occurrence of pathological rearrangement in the bone stump and ways to prevent it remain unexplored.

Aim:
To study the nature of changes in the structural organization of bone stump after amputation.

Material and methods:
Nine series of experiments were conducted on 129 rabbits with amputation of the thigh and closure of the filing with fascia, muscles with varying degrees of tension and a bone plate. Duration of observation is 1, 3, and 6 months. The research method is histological with a filling of blood vessels with a mascara-gelatin mixture.

Results and discussion:
Tight closure of the bone marrow cavity and uniform muscle tension during plastic surgery in the I–III series of experiments make it possible to obtain cylindrical stumps with the formation of a bone closure plate and the completion of the reparative process. In the majority of observations of the IV–IX series, significant violations of the structural organization of the bone occurred in the form of conical, club-shaped, swollen stumps, creeping fractures.

Conclusions:
The rapid completion of the reparative process and the normalization of intraosseous circulation with a locking bone plate, while maintaining normal bone marrow tissue, is possible only with a dense closure of the filing. The lack of tight closure of the bone marrow canal and uneven muscle tension cause a violation of regeneration with changes in the structural organization of the bone. These changes are manifested by a thickening of the bone diameter, axis curvature, creeping fractures.

CONFLICT OF INTEREST
None declared.
FUNDING
None declared.
 
REFERENCES (11)
1.
Brusko AT, Gayko GV. Functional Bone Remodeling and Its Clinical Significance. Lugansk: Lugansk State Medical University. 2005;212.
 
2.
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....
 
3.
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.....
 
4.
Bezsmertnyi YO, Shevchuk VI, Grushko OV, et al. Information model for the evaluation of the efficiency of osteoplasty performing in case of amputations on below knee. Proc. SPIE 10808, Photonics Applications in Astronomy, Communications, Industry, and High-Energy Physics Experiments 2018, 108083H. https://doi.org/10.1117/12.250....
 
5.
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....
 
6.
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....
 
7.
Nannaparaju M, Annavaram K, Anwar R, Khan WS, Hambidge J. Serial femoral fractures in an amputation stump: A case report. Open Orthop J. 2017;11:316–320. https://doi.org/10.2174/187432....
 
8.
Plucknette BF, Krueger CA, Rivera JC, Wenke JC. Combat-related bridge synostosis versus traditional transtibial amputation: comparison of military-specific outcomes. Strategies Trauma Limb Reconstr. 2016;11(1):5–11. https://doi.org/10.1007/s11751....
 
9.
Ranz EC, Wilken JM, Gajewski DA, Neptune RR. The influence of limb alignment and transfemoral amputation technique on muscle capacity during gait. Comput Methods Biomech Biomed Engin. 2017;20(11):1167–1174. https://doi.org/10.1080/102558....
 
10.
Wenig W, Zhao B, Lin D, Gao W, Li Z, Yan H. Significance of alpha smooth muscle actin expression in traumatic painful neuromas: A pilot study in rats. Sci Rep. 2016;6:23828. https://doi.org/10.1038/srep23....
 
11.
Zhang X, Xu Y, Zhou J, Pu S, Lv Y, Chen Y. Ultrasound-guided alcohol neurolysis and radiofrequency ablation of painful stump neuroma: Effective treatments for post-amputation pain. J Pain Res. 2017;10,295–302. https://doi.org/10.2147/JPR.S1....