The bone-myoplastic amputation and reamputation below the knee
The analysis of 340 amputations and reamputations below the knee was carried out. In 206 cases (experimental group), osteomuscular plastic was performed with the closure of the medullary canal by a thin cortical plate, the formation of a synostosis between the truncated bones and muscle plasty with the fixation of the muscles to the bone and the graft. In the control group, traditional myoplasty was performed with the stitching of antagonist muscles under the bone saw (134 patients). The observation period is 2–10 years. Methods of investigation: clinical, radiological, CT, ultrasound, tonicometry, tensometry, measurement of intraosseous pressure, morphological. Closure of the medullary cavity led to the restoration of intraosseous pressure, a rapid (1–2 months) formation of the bone closure plate, the preservation of the shape and the structure of the bone stump. Bone synostosis prevented the ballot of the fibula. Fixation of muscles to the bone provided a good closure of the filings and the formation of a hardy muscle stump. The amputation stumps after bone-myoplastic amputations become durable, functional, painless and long lasting. Any of cases required a reamputation. In the control group, the formation of the osseous occlusal plate was violated in most of the observations, there was a resorption of the cortical bone, much more muscle was atrophy, there was a pain syndrome of varying intensity. In a number of cases reamputation or reconstructive operations were required.
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