THE RELATIONSHIP OF CLINICAL AND MORPHOLOGICAL DATA IN COMMINUTED FRACTURES OF THE LOWER JAW

Abstract

The aim is to establish the relationship between some clinical, physiological and morphological parameters in patients with the consequences of an acute injury considering the features of pathological and reparative changes in the bone fragments of the lower jaw formed during a fracture using clinical and morphological methods. Materials and methods: The material of the study was bone fragments of the lower jaw, removed during osteosynthesis operations in 20 patients with traumatic comminuted fractures. Also, the material of the study was the data obtained during the examination of the above patients. Morphological parameters characterizing the state of the fragments tissues removed during surgical treatment of fractures of the lower jaw and clinical parameters characterizing the patient’s condition in cases of traumatic fractures of the lower jaw treatment were identified for frequency and correlation analysis. Different of frequency of individual indicators’ gradations cases was determined by the χ-square test, correlations between parameters (correlations of pairs of parameters “clinic – morphology”, “clinical and laboratory data – morphology”) – by calculating the Pearson association coefficient. Results: The main pathological and reparative changes are determined in the bone fragments of the lower jaw after a traumatic fracture: osteomedullary ischemic necrosis (traumatic bone infarction), nonspecific productive inflammation, endosteal and periosteal bone regenerates. The severity and frequency of pathological and reparative changes in the bone fragments of the lower jaw vary, leading to various correlations between clinical and morphological indicators of the fragment tissues conditions. Reliable correlations were established between individual clinical and morphological indicators of the state of bone fragments corresponding to the values of the association coefficient in the range of 0.3-0.7, in particular: in the pair “age of the patient” – “endosteal regenerates” – the dependence is negative, of medium strength, significant (p<0.05); in the pair “age of the patient” – “periosteal regenerates” – the dependence is negative, of medium strength, significant (p<0.05); in the pair “fragment surface area” – “osteonecrosis” – the relationship is negative, weak, significant with the probability of error in assessing the value |ra| p<0.1; in the pair “locus of a fracture in the lower jaw” – “type of inflammation in the bone marrow” – the dependence is positive, of medium strength, highly reliable (p<0.01). Conclusions: A comprehensive clinical and morphological examination made it possible to calculate quantitative data that characterize the frequency parameters of the occur¬rence of certain pathological changes in the bone fragments of the lower jaw after a fracture and the features of individual clinical and morphological parameters conjugation in patients with the consequences of a mechanical jaw injury. The obtained data on the correlation dependences of the type “clinic – morphology” can be used to predict the severity of morphological parameters according to the known values of clinical parameters in patients with the consequences of mandibular fractures.