Impact of post- amputation pain syndrome on the results of bone stump formation

Authors

DOI:

https://doi.org/10.26641/1997-9665.2021.3.50-56

Keywords:

amputation, pain syndrome, neuritis, reparative regeneration

Abstract

Background. To the present day, a high rate of unsatisfactory amputation results still exists. The healing of the bone residual limb, the main support element of the residual limb, is of particular importance. Objective. To study the impact of postamputation pain syndrome on the nature of reparative processes in the bone residual limb. Methods. Three series of experiments were performed on 45 rabbits, 15 in each with mid-third thigh amputation and muscular plasty. In series 1 and 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 1% lidocaine was injected through the catheter into the circumference of the nerve twice daily for 20 days. Animals of series 3 served as 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. In series 1, there was a sharp disturbance of the reparative process, which consisted in shape changes, resorption of the cortical diaphyseal plate, stump deformity, absence of bone closure plate formation, and microcirculatory disturbances. In most experiments of the 2nd series, organotypic stumps were formed with normalized microcirculation. In series 3, the results of the residual limb formation were better than in series 1, but worse than in series 2. Conclusion. In the absence of pain syndrome, the bone stump after amputation at the diaphysis level over a period of 1, 3, 6 months retains its cylindrical shape, the structure of the cortical diaphyseal plate, the content of the medullary canal with normal microcirculation, the formation of the bone closure plate, and the completion of the reparative process. The presence of postamputation pain syndrome in the stump distorts the course of the reparative process with the development of pathological remodeling of bone tissue.

References

  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/10.4103/0973-1075.197944.
  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.JOACP_126_17.
  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. Scandinavian Journal of Pain. 2019;19(4):779–787. https://doi.org/10.1515/sjpain-2019-0045.
  4. Shevchuk VI, Bezsmertnyi YO, Bezsmertna GV, Dovgalyuk TV, Jiang Y. Peculiar features of regeneration at the end of bone filing after amputation of a limb. World of medicine and biology. 2021;1(75):229-234. https://doi.org/10.26724/2079-8334-2021-1-75-229-234.
  5. Shevchuk VI, Bezsmertnyi YO, Bezsmertna HV, Dovgalyuk TV, Jiang Y. Reparative regeneration at the end of bone filing after ostoplastic amputation. Wiadomości Lekarskie. 2021;74(3):413 417. https://doi.org/10.36740/WLek202103106.
  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. DOI:10.1016/j.ejvs.2015.04.030.
  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.0000000000001705.
  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. DOI:10.1177/1534734616657964.
  9. Buchheit T, Hsia HJ, Cooter M, Shaw A, Van de Ven T. 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/pnz067.
  10. Dumanian GA, Potter BK, Mioton LM, Ko JH, Cheesborough JE, Souza JM, Ertl WJ, Tintle SM, Nanos GP, Valerio IL, Kuiken TA, Apkarian AV, Porter K, Jordan SW. 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.0000000000003088.
  11. Gilmore C, Ilfeld B, Rosenow J, Li S, Desai M, Hunter C, Rauck R, Kapural L, Nader A, Mak J, Cohen S, Crosby N, Boggs J. 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-2018-100109.
  12. Grjibovski AM, Ivanov SV, Gorbatova MA. Descriptive statistics using Statistica and SPSS software. Nauka i Zdravookhranenie [Science & Healthcare]. 2016;(1):7-23. https://doi.org/10.34689/SH.2016.18.1.001.
  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 i Zdravookhranenie [Science & Healthcare]. 2016;(2):5-28. https://doi.org/10.34689/SH.2016.18.2.001.

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Published

2021-12-25

How to Cite

Impact of post- amputation pain syndrome on the results of bone stump formation. (2021). Морфологія / Morphologia / Morfologìâ, 15(3), 50–56. https://doi.org/10.26641/1997-9665.2021.3.50-56

Issue

Vol. 15 No. 3 (2021)

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Статті

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