Features of Radiologic Diagnostics in the Determination of Femoral Stump Defects in Primary Prosthetics

Abstract

This work is based on a clinical and laboratory study of 43 patients and persons with disabilities who underwent primary prosthetics of the hip stump. Observations were carried out in the period after surgery from 1 month to 6 months in the period from 2014 to 2019 at the clinic of the National Center for Rehabilitation and Prosthetics of Persons with Disabilities. Post-traumatic amputation of limb segment most often occur in patients of young working age, which determines the great socio-economic significance and relevance of reconstructive operations. After amputation of the limb, the processes of restructuring of the tissues of the stump occur under new conditions of blood circulation. Changes in the circulatory system are associated with narrowing of blood flow and thickening of the walls of large arterial and venous vessels, as well as an increase in the number and caliber of capillaries. The defects of the stump are very diverse, these are short and excessively long stumps, the high location of truncated muscle to the skin scar, etc. Diseases of the stump (osteonecrosis, osteophytes, osteomyelitis, phantom pain, ligature fistulas and long-term non-healing wounds) and the result of technical errors in surgical interventions, wound infection and irrational prosthetics. Based on this, it is advisable to use early Doppler ultrasound and X-ray diagnostics in determining malformations and diseases of the stump in order to carry out primary prosthetics. Express prosthetics of the amputation stump in post-traumatic amputations gives a high rehabilitation effect compared to other pathologies: both vascular and other systemic pathologies. The results of complex studies are presented: clinical (orthopedic, neurological), psychological, X-ray, ultrasound, Doppler ultrasonography.