Bilateral Stress Fractures of Amputated Tibial Stumps in the Setting of Chronic Compartment Syndrome.

Introduction: Limb amputation and subsequent prosthetics lead to significant disturbances in bone residual limb remodeling.

Aim: To familiarize specialists with the possibility of simultaneous bilateral stress fractures of amputation residual limbs resulting from intensive loads and poor-quality prosthetics causing chronic compartment syndrome. A case of bilateral stress fractures of the tibia in a 28-year-old male military serviceman with paired transtibial amputation is presented.

Ertl surgery on the short fibula stump after war injury.

Aim: To propose a new technique of Ertl-type surgery for significantly shortened and valgus deviated fibula stump.

Methods: We present the case of a 26-year-old patient who underwent reamputation surgery to replace a significantly shortened fibula stump using a distraction regenerate formed after tibial stump osteotomy and dosed distraction of the autograft using the Ilizarov apparatus. Its advantage is the elimination of valgus deviation of the fibula remnant, its lengthening, formation of bone synostosis, and increase of the bearing surface, which provides the possibility of total contact prosthetics.

Reconstruction of a Short Tibial Stump with a Long Fibula Using the Ilizarov Technique: A Case Study.

The creation of a functional tibial stump after combat injuries is sometimes too difficult. We describe a case of high amputation after a mine-blast injury. In this case, the tibia stump was too short (5 cm) and the fibula stump was too long (12 cm).

Bone Bridge Transtibial Amputation by an Innovative Technique.

We present a case report of synostosis after transtibial amputation because of distraction regenerate formation after decortication of the lateral surfaces of the tibia and fibula, sequential compression, and distraction using the Ilizarov apparatus. Its advantage is that there is no need to shorten bone. The establishment of distal tibia-fibula synostosis (Ertl) in patients with transtibial amputation has been advocated to improve function and prosthetic wear.

Modification of Ertl Operation for Short Stump.

Background: Despite a sufficient number of papers on the technique of transtibial amputations, the technique of Ertl-type reamputation in short tibial stump remains unreported.

Aim: To propose a modification of the Ertl operation in the proximal tibia.

Case Presentation: The technique of bone bridge creation in a patient with a malformed stump in the upper third of the tibia at the expense of the regenerate formed after corticotomy of the tibial remnant and dosed distraction of the graft by the Ilizarov apparatus is described.

Remodeling of the Fibula Stump After Transtibial Amputation.

Aim: To study the peculiarities of peroneal stump remodelling after transtibial amputation in the process of prosthesis usage.

Material And Methods: A histological study of the ends of the stumps of the fibula in 68 patients was performed. Terms after amputation: 2-8 years.

Vascularization of a bone stump.

Aim To study the character of blood circulation in the bone stump at tight and loose closure of the medullary cavity. Methods Two series of experiments on 39 rabbits with mid-third femoral amputation and muscular plasty were carried out. In the 1st (experimental) series, the bone scapula was closed by thin cortical autograft taken from the epimetaphyseal area, and then the muscles were sutured, and in the 2nd - the scapula was closed by myoplasty only.

Bone healing during electrostimulation.

Aim To investigate the effect of direct epineural electrical stimulation of the nerve on the nature of reparative processes in the bone stump. Methods Three series of experiments were carried out with amputation of the thigh in the middle third and muscle plasty. In the 1st and 2nd experimental series a perineural catheter was brought to the stump of the sciatic nerve, through which mechanical irritation of the nerve was performed for 20 days daily for 20 minutes.

BIOMECHANICAL FACTORS IN RESIDUAL LIMB FORMATION AFTER AMPUTATION.

Objective: The aim: To study the influence of biomechanical factors on the character of morphological disorders in the process of reparative regeneration at the end of the residual limb after amputation.

Patients And Methods: Materials and methods: 10 series of experiments on 144 rabbits were conducted. We used myodesis with normal, insufficient and excessive muscle tension, their electrical stimulation, tight and leaky closure of the bone marrow canal.

Reamputation stumps below knee.

Aim To investigate rehabilitation outcomes of patients with malformed tibial stumps. Methods Observations included 421 patients with residual limb diseases and malformations (extensive inactive scars adhered to the bone, excessively long or short stumps, bone filing, osteomyelitis of the stump, muscle attachment to the skin scar, excessive mobility and deviations of the fibula, improper filing). Four hundred and thirty-six (436) reconstructive surgeries were performed.

REPARATIVE REGENERATION AT THE END OF BONE FILING AFTER OSTOPLASTIC AMPUTATION.

Objective: The aim: To study the role and place of bone grafting in the formation of bone stump after amputation.

Patients And Methods: Materials and methods: 3 series of experiments were carried out on 44 rabbits with amputation of the thigh in the middle third and stump grafting using osteoplastic hermetic closure of the canal with a thin cortical plate (series I), closure of the canal with a spongy bone (series II), and loose closure of the canal with a cortical graft located at the entrance to the canal at an angle of 30° (ІІІ series). Observation period: 1, 3, 6 months.

The relationship between homocysteine level and vitamins B12, B9 and B6 status in patients with chronic kidney disease.

Objective: Introduction: According to present knowledge, hyperhomocysteinemia is one of the risk factors of cardio-vascular pathology. Patients with chronic kidney disease are known to develop hyperhomocysteinemia more often than those in general population. Іmportant cause of hyperhomocysteinemia is the deficiency of vitamins В6, В9 and В12 that are involved in homocysteine metabolism.