Bessmertniy Y. Prophylaxis and treatment of local painful syndrome of lower extremity amputation stumps.

Objective:To increase prophylaxis efficacy and treatment of local painful syndrome of amputation stumps based on deep studying pathogenesis and differential approach considering disease forms,clinical course particularities,prosthetics character,physiological and biochemical experimental findings.Cases:Patients with lower extremity amputation stumps.Methods:clinical,radiological,physiological (measure of intraosteal and subfascial pressure,oxygen tension indentification in soft tissue,painful pressor sensitivity,electroneuromyography,opticoelectron plethysmography,noninvasive,biochemical,morphological and statistic methods.Scientific novelty.The local painful syndrome forms of lower extremity amputation stumps not described previously were determined:osteomyodystrophy syndrome,fibula stump syndrome,tunnel neuropathy,chronic compartment syndrome.Amputation proved to be rather frequent intermedi-ate stage in painful syndrome occurrence and the starting point is a persistent hypokinesia prior to the amputation.The local painful syndrome such as chronic compartment syndrome, tunnel neuropathy, fibula stump syndrome were found to develop because of prosthetics with amputation technique violation and local circulatory distress; osteo-myodystrophy syndrome was due to the amputation, the amputation plasty and course characteristics of the postop-erative period and prosthetics terms. First the primary early prosthetics was shown to be an effective factor for the local painful syndrome occurence. The special effect of lipid peroxide oxidation markers, oxidation protein destruction, inflammation, proinflammatory cytokines on the intensity and the painful syndrome course were investigated. Results of the investigation are put into the practice in Ukraine State research institute of invalid rehabilitation, Vinnitsa state prosthetic orthopedic enterprise and the Pirogov Regional hospital, Research institute of traumatol-ogy and orthopedics of Ukraine Medical Science Acad-emy. Main theses of the dissertation are used ineduca-tional process at the chairs of traumatology and orthope-dics in the Pirogov Vinnitsa National Medical University. Traumatology and orthopedics.