CIRCULATION IN STUMP OF BONE AT VARIOUS METHODS OF AMPUTATION PLASTICS

Abstract

The purpose of the study was to determine the most effective methods of amputation plasty, which provide adequate blood circulation in the bone stump. Three series of experiments were performed on 75 dogs with closure of the sawdust with myodesis, a combination of myodesis with bone plasty with a thin cortical plate taken from the part of the limb to be removed (main groups), fascioplastic and myoplastic, with the cross-linking of the antagonist muscles under the sawdust (control group). The observation period was1, 3, 8 months. The advantage of dense closure of the medullary cavity with the help of myodesis and its combination with bone plasticity by a thin cortical plate has been proved. Restoration of intraosseous pressure disturbed during amputation during a month period occurs only with myodesis with tight closure of muscles and bone plastic with a thin cortical plate tightly laid at the edge of the open bone marrow cavity. With fascio- and myoplasty in the next time (1–3 months), it is low, and in the distant (8 months) – high, due to pronounced venous stasis. Restoration of the impaired closure of the medullary cavity is achieved already during the operation, which ensures complete compression of the lumen of the feeding artery along with the venous sinus, and rapid formation of the osseous occlusal plate with restoration of normal intraosseous circulation. With fascio- and myoplastic amputation, incomplete closure of the medullary canal with tissues is an obstacle to powerful blood flow along the intraosteal main vessels, which under its influence become convoluted and form vascular conglomerates. The latter, occupying the lumen of the medullary canal, create a mechanical obstacle to the restoration of the closed bone marrow cavity necessary for normalization of intraosseous microcirculation.