Dynamics of the speed of blood flow in the arteries of the bone regenerate of the limbs and in the brain arteries during functional tests and changes in the treatment mode

Abstract

The results of a comparative study of the linear velocity of blood flow in the arteries of the bone regenerate in patients with fractures of the leg and shoulder bones and in the process of Ilizarov treatment are analyzed. Studies were conducted at rest and when performing a number of functional tests (orthostatic, muscular and with a dosed axial load on the limb). The effect of stress on the state of regional and cerebral blood flow in the conditions of inpatient treatment and after the transfer of patients to the outpatient treatment regimen was assessed.Material and methods. 41 adult patients with a closed diaphyseal fracture of the humerus and 57 patients with a fracture of the tibia bones during Ilizarov treatment were examined. The blood flow in the regenerate and along the middle cerebral arteries was determined by the method of ultrasonic doppler sonography.Results. With an increase in the functional load on the limb in patients with fractures of the humerus and tibial bones, respectively, up to 10 and 30 kgf, a temporary increase in the blood flow velocity in the arteries of the bone regenerate was observed. Large values of the load on the lower leg, accompanied by the acceleration of blood flow, indicate a better protection of the vascular bed of the tibial regenerate. The magnitude of the decrease in blood flow velocity in the regeneration of the lower leg arising from the behavior of an orthostatic test in the course of treating patients increased from 21 to 37 %, and indicated an increase in the reactivity of the vascular bed. In patients with injuries of the shoulder and lower leg, the transfer to the outpatient treatment regimen was accompanied by a statistically significant (p≤0.001) increase in the duration of the fixation period, respectively, to 82±3 and 94±7 days, a decrease in the increased blood flow velocity in the middle cerebral artery on the contralateral side by 43 % and 57 % and an increase in the magnitude of changes in cerebral blood flow rate during functional muscle test by 50 and 67 %.