Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2016 Vol. 24 No 1

GENERAL & SPECIAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2016.1.55   |  

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 51,415,8 years (MS). 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). Spearmans 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=6,70,8; 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=4,10,6; 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=9,20,7 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
References
  1. Kotel'nikov GP, Ryzhov PV, Losev II, Chernov AP. Lechenie povrezhdenii i zabolevanii golenostopnogo sustava i stopy [Treatment of injuries and diseases of the ankle and foot]: monogr. Moscow, RF: GEOTAR-Media; 2012. 362 p.
  2. Katorkin SE, Losev II, Sizonenko YV. Patients with venous and musculoskeletal disorders of the legs: functional and clinical methods for diagnosis and therapy. Vasomed. 2014;26(1):6-8.
  3. Sushkov SA, Kukhtenkov PA, Nebylitsin IuS, Sushkova OS. Fenotipicheskii simptomokompleks displazii soedinitel'noi tkani pri nedostatochnosti glubokikh ven u bol'nykh varikoznoi bolezn'iu [Phenotypic dysplasia syndrome complex of connective tissue in patients with deep vein varicose]. Novosti Khirurgii. 2006;14(2):32-37.
  4. Kosinets AN, Sushkov SA. Varikoznaia bolezn' [Varicose veins]: ruk dlia vrachei. Vitebsk, RB: VGMU; 2009. 415 p.
  5. Recek C. Calf pump activity influencing venous hemodynamics in the lower extremity. Int J Angiol. 2013 Mar;22(1):23-30. doi: 10.1055/s-0033-1334092.
  6. Uhl JF, Gillot C. Anatomy of the veno-muscular pumps of the lower limb. Phlebology. 2015 Apr;30(3):180-93. doi: 10.1177/0268355513517686.
  7. Katorkin SE, Iarovenko GV, Myshentsev PN, Sizonenko IaV. Osobennosti biomekhanicheskikh izmenenii oporno-dvigatel'noi sistemy pri khronicheskoi limfovenoznoi nedostatochnosti nizhnikh konechnostei [Features the biomechanical changes in the musculoskeletal system in chronic lymphovenous insufficiency of the lower limbs]. Novosti Khirurgii. 2010;18(6):50-57.
  8. Shcheglov EA, Vezikova NN. Effektivnost' khirurgicheskogo lecheniia varikoznoi bolezni u patsientov s khronicheskoi venoznoi nedostatochnost'iu v sochetanii s gonartrozom [The effectiveness of surgical treatment of varicose veins in patients with chronic venous insufficiency in conjunction with gonarthosis]. Uchenye Zap Petrozavod Gos Un-ta. 2012;(6):55-58.
  9. Bogachev VY, Lobanov VN, Golovanova OV, Kuznetsov AN, Yershov PV. Electrical muscle stimulation with Veinoplus device in the treatment of venous ulcers. Int Angiol. 2015 Jun;34(3):257-62.
  10. Arnoldi CC, Linderholm H, Müssbichler H. Venous engorgement and intraosseous hypertension in osteoarthritis of the hip. J Bone Joint Surg Br. 1972 Aug;54(3):409-21.
  11. Uchio Y, Ochi M, Adachi N, Nishikori T, Kawasaki K. Intraosseous hypertension and venous congestion in osteonecrosis of the knee. Clin Orthop Relat Res. 2001 Mar;(384):217-23. doi: 10.1097/00003086-200103000-00025.
  12. Simkin PA. Bone pain and pressure in osteoarthritic joints. Novartis Found Symp. 2004;260:179-86; discussion 186-90, 277-79.
  13. Shcheglov EA, Vezikova NN, Kartsova IV, Rybakov VI, Kheifets IV. Algoritm ul'trazvukovoi diagnostiki pri sochetanii varikoznoi bolezni i osteoartroza kolennykh sustavov [The algorithm of ultrasound diagnosis of varicose veins and osteoarthritis of the knee]. Vestn Eksperim i Klin Khirurgii. 2012;V(1):114-19.
  14. Shevchenko IuL, Stoiko IuM, Gudymovich VG, Ivanov AK. Kompleksnyi podkhod v lechenii obshirnykh troficheskikh iazv golenei v mnogoprofil'nom statsionare [A comprehensive approach in the treatment of extensive venous leg ulcers in multidisciplinary hospital]. Vestn Eksperim i Klin Khirurgii. 2014;7(3):221-27.
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".
Contacts | ©Vitebsk State Medical University, 2007