Key result
Repeated revascularizing osteotrepanation preserved limb supporting function in 81.5% of lower extremities and maintained functional state in all upper extremities with stage IV chronic ischemia.
Why the study?
The study evaluated the results of repeated revascularizing osteotrepanation in patients with critical ischaemia of the upper and lower extremities to prevent major amputations.
Does repeated revascularizing osteotrepanation prevent major amputations in patients with critical ischemia of the upper and lower extremities?
Observational (n=27)
Does repeated revascularizing osteotrepanation prevent major amputations in patients with critical ischemia of the upper and lower extremities?
Repeated revascularizing osteotrepanation may help prevent major amputations and preserve limb function in patients with critical limb ischemia.
May support limb salvage in critical ischemia; leaves open need for prospective trials before adoption.
Purpose: To study the results of repeated revascularizing osteotrepanation in patients with critical ischaemia of the upper and lower extremities in order to prevent major amputations.Material and methods: The etiological cause of the development of CI was thromboangiitis obliterans (OT) in 9 patients, Raynaud's syndrome (disease) in 4 patients, obliterating atherosclerosis in 5 patients, obliterating atherosclerosis with concomitant type 2 diabetes mellitus in 9 patients.According to the Fontaine-Pokrovsky classification, 10 patients had stage III of chronic ischemia, and 17 patients had stage IV of chronic ischemia.The terms of repeated revascularizing osteotrepanation are from 3 months.up to 2 years after the first ROT.Results: Repeated operation of oral rotation of the ulna and radius was performed in 15 extremities with stage IV chronic ischemia.In 3 (20.0%)extremities, the necrotic wound on the fingers healed, in 5 (33.3%) soft tissue necrectomy was performed, in 7 (46.7%)casesminor amputations at the level of the fingers.Amputation at the level of the forearm was not performed.Repeated operation of tibial rot was performed in 24 limbs with stage IV chronic ischemia.In 7 (25.9%)limbs, the necrotic wound healed, in 6 (22.2%) limbs, soft tissue necrectomy was performed, in 9 (33.3%)limbs -minor amputations, in 5 (18.5%) -due to the progression of critical ischemia, amputation was performed at the level of the upper third of the tibia (major amputation).In 22 (81.5%)cases with stage IV chronic ischemia, the supporting function of the limb was preserved.Conclusion: With repeated ROT, the frequency of high amputations of the upper and lower extremities decreases.Out of 22 limbs with stage IV of chronic ischemia of the lower extremities, 15 (81.5% of cases) managed to preserve the supporting function.In all 20 cases with stage IV chronic ischemia of the upper extremities, it was possible to maintain the functional state of the limb.
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A 2025 study conducted an observational in Critical ischemia of the upper and lower extremities (n=27). Repeated revascularizing osteotrepanation was evaluated on Major amputation and preservation of limb supporting function. Repeated revascularizing osteotrepanation preserved limb supporting function in 81.5% of lower extremities and maintained functional state in all upper extremities with stage IV chronic ischemia.
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