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Fast and slow myosin as markers of muscle regeneration in mangled extremities: a pilot study

  • Original Article • LIMBS - TRAUMAS
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Mangled extremities were classically managed by amputation. But over the past few decades, with the advancement in surgical techniques, an increased number of limb salvages have been possible. As muscles usually get damaged in such grievous injuries, a thorough understanding of muscle regeneration may give a better insight into muscle healing in these injuries. Muscles are composed of slow and fast fibers which can be represented by slow and fast myosin, respectively. There are some animal studies which reported differential regeneration of slow and fast muscle fibers during muscle healing. We conducted this pilot study to find out whether the same holds true for muscle healing in mangled extremities also. This pilot study is designed in 15 patients with lower limb mangled extremities presenting to trauma center of PGIMER, Chandigarh, who were operated within 24 h of injury to see whether muscle healing in mangled extremities follows the same pattern. Biopsies were taken during initial surgery conducted within 24 h of injury and on the 7th day of injury when patient was posted again for secondary wound closure procedure or revision amputation. The biopsy samples were subjected to histopathological and immunohistochemistry examination using antibodies against fast and slow myosin. We found that the regenerating muscle fibers in the biopsy sample taken on the 7th day of injury showed only slow muscle fibers with the absence of fast muscle fibers when compared with the initial biopsy results showing differential regeneration of slow muscle fibers.

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Funding

This study was funded by Indian Council of Medical Research (ICMR), Department of Health Research, New Delhi, India.

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Authors and Affiliations

  1. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), SECTOR - 12, Chandigarh, 160012, India

    Guruaribam Rishikanta Sharma, Vishal Kumar, Rajendra Kumar Kanojia & Rohit Kansal

  2. Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Kim Vaiphei

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  1. Guruaribam Rishikanta Sharma
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  2. Vishal Kumar
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  3. Rajendra Kumar Kanojia
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  4. Kim Vaiphei
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  5. Rohit Kansal
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Corresponding author

Correspondence to Rajendra Kumar Kanojia.

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Conflict of interest

There is no conflict of interest from any of the authors.

Ethical standard

The study was approved by the Institute’s Ethical Committee and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was taken from the patients at the time of enrollment, the study procedure was explained in detail to all the enrolled patients, and they were made to understand that they could withdraw from the study at any point of the study period. The study has not altered any of the management protocols of these patients. Identity of the participants was kept confidential.

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Sharma, G.R., Kumar, V., Kanojia, R.K. et al. Fast and slow myosin as markers of muscle regeneration in mangled extremities: a pilot study. Eur J Orthop Surg Traumatol 29, 1539–1547 (2019). https://doi.org/10.1007/s00590-019-02448-w

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  • DOI: https://doi.org/10.1007/s00590-019-02448-w

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