HISTOLOGICAL CHANGES AND CORRELATION OF MORPHOLOGICAL INDICES OF INJURY AND REPAIR IN BONE SPLINTS IN COMMINUTED MANDIBULAR FRACTURES
DOI:
https://doi.org/10.35220/2078-8916-2020-38-4-63-72Keywords:
mandible fracture, comminuted fractures of the mandible, morphohistological changes in fragmentary fractures of the mandibleAbstract
Relevance. At comminuted fractures of the mandible, the success of treatment determined by the course of repara-tive processes in the area of injury. In this regard, the minimally invasive approaches, optimization of condi-tions of reparative regeneration and methods of preven-tion of purulent-inflammatory complications in this cate-gory of patients attract significant interest of researchers.
At the same time, analytical studies that would establish the condition of the tissues of the fragments of the mandi-ble after mechanical injury, has not been conducted be-fore. The relationships between the individual morpholog-ical parameters that reflect the condition of the mandibu-lar tissue located in the area of injury are also not char-acterized.
Aim. Study of clinical and morphological features of pathological and reparative changes in the bone frag-ments of the mandible.
Materials and methods. The study was based on frag-ments of bone fragments of the mandible obtained during open reduction and internal fixation in 20 patients with traumatic fractures. The operations were performed ac-cording to the indications and consisted of reduction the fragments, removing small splints (they were used for his-tological examination) and installing fixators to reposi-tion the fragments of the injured bone.
Results and discussion. The results of our study showed that ischemic bone injury of varying length after traumat-ic fractures occurred in the mandible, causing an inflam-matory reaction of varying degrees and reparative reac-tion of the endosteum and periosteum. Histological mani-festations of these changes varied and in most cases the severity is weakly correlated with each other. Only the indicators "type of inflammation in the bone marrow" and "periosteal regenerate" show a significant negative rela-tionship in the range of average values of the coefficient of association.
Conclusions. From correlations between separate mor-phological indicators of a condition of bone fragments the highest parameter with reliable negative value of coeffi-cient of association in the range of average values of tightness is established between "a kind of an inflamma-tion in a bone marrow" of a fragment – and "expressive-ness of periosteal regenerates". The activity of the in-flammatory process and the size of the periosteal regen-erates are in the feedback, which suggests the negative impact of the inflammatory process on the development of periosteal reparative reaction of bone fragments.
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