Year 2016 Vol. 24 No 1

GENERAL & SPECIAL SURGERY

Y.V. SIZONENKO, S.E. KATORKIN, I.I. LOSEV

DYSFUNCTION OF VENOUS PUMP MUSCLES IN PATIENTS WITH COMBINED LESION OF MUSCULOSKELETAL AND VENOUS SYSTEMS OF THE LOWER LIMBS

SBEE HPE "Samara State Medical University",
The Russian Federation

Objectives. To reveal the main factors reliably influencing the function of the muscular-venous pump of the lower limbs at the combined lesions of the musculoskeletal and venous systems.
Methods. The study was conducted in the laboratory of clinical biomechanics in the period from 2014 to 2015. The study included patients (n=37) with combined lesions of the musculoskeletal and venous systems of the lower limbs. The average age of patients was 51,4±15,8 years (M±S). Podometrics, functional electromyography, plantography, statistical analysis of the obtained data were carried out.
Results. Functional impairment of venous pump in the tibia is 74%, in the hip – 81%. Significant reduction in the bioelectric activity of m. gastrocnemius medialis (maxav.<120 mkV at an average rate of 312 mkV) and m. vastus medialis (maxav.<110 mkV at an average rate of 162 mkV). Spearman’s correlation showed a strong relationship between the maximum of m. gastrocnemius med. reduction (R=0,88; p<0,001) and m. vastus med. (R=0,94; p<0,001). The moderate correlation was found between indicators of function of tibial and femur pump (R=0,52; p<0,001). There is the effect of lameness on the dysfunction of the tibial venous pump (χ2emp.= 8,1; p<0,05 and χ2kr. = 5,9; OR=6,7±0,8; CI=1,4-31,2). In all cases a transverse flatfoot was revealed. In 77% of cases the pathology of the longitudinal arch of the foot and its impact on the dysfunction of the tibial (χ2emp.=10,7 at p<0,05 and χ2kr.=9,5) and femur venous pump (χ2emp.=7,1 for p<0,01 and χ2kr.=6,6; OR=4,1±0,6; CI=1,4-14,9) had been established. Hallux valgus was diagnosed in 74% of cases. Foot hyperpronation was diagnosed in 69% of cases, which statistically affect the function of the venous pump (χ2emp.=12,9; p<0,01 and χ2kr.=6,6; OR=9,2±0,7 DI=1,9-18,2).
Conclusion. Biomechanical studies have revealed the deficits in muscle function, violations of the act of walking, foot pathology that should be maximally eliminated with the use of orthopedic aids, physical therapy and physiotherapy.

Keywords: chronic venous diseases, muscular-venous pump, flatfoot, podometrics, functional electromyography, plantography, biomechanics
p. 55-61 of the original issue
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Address for correspondence:
443079, Russian Federation, Samara,
pr. Karla Marksa, d. 165 "b".
Kliniki Samarskogo gosudarstvennogo meditsinskogo universiteta,
laboratoriya klinicheskoy biomehaniki.
tel. mob. 7 917 116-86-35,
e-mail: iva3633@gmail.com,
Sizonenko Yaroslav Vladimirovich
Information about the authors:
Sizonenko Y.V. PhD, a head of the laboratory of clinical biomechanics of clinics of SBEE HPE "Samara State Medical University".
Katorkin S.E. PhD, an associate professor, a head of the chair and clinic of hospital surgery of SBEE HPE "Samara State Medical University".
Losev I.I. MD, professor of the chair and clinic of traumatology, orthopedics and extreme surgery of SBEE HPE "Samara State Medical University".
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