Bone Vascularization and Bone Healing in the Amputation Stump: An Experimental Study

Abstract

The osseous healing process of the amputation stump was investigated in adult rabbits. Histological investigation showed that the medullary cavity was closed after 2–3 weeks, chiefly by endosteal callus. After closure of the cavity there was a gradual spongious change in the bone tip and simultaneously the cortex atrophied and the medullary cavity dilated. After amputation on the crus bone rebuilding dominated, whereas after amputation on the femur deterioration of bone was most noticeable. A combination of amputation and medullary plugging caused a change in the course of healing. The medullary cavity did not close until 7–10 weeks after operation and there was distinct periostea] callus formation. The microangiographic investigation showed a transient hyper-vascularization in the cortex 3–4 weeks after amputation; whereas after simultaneous plugging of the medullary cavity the hypervasculari-zation continued for up to 7 weeks after operation. Following amputation proximally on the crus the arterial supply of the cortex came mainly from the periost, whereas the cortex after distal amputation was vascularized from the medullary cavity. This finding can be due to an interruption of the arterial supply from the nutrient artery associated with proximal amputation, whereas this artery remains intact with amputation distally on the crus.