Lesnuhin V. The features of diagnostics of the clinical course and treatment of the fractures of the mandibulae that are followed by damages of the mental nerve.

The dissertation is dedicated to the study of condition and treatment of the mental nerve in cases with fractured body of the mandibulae. 147 patients were evaluated and treated, the cases were divided into three groups: I group (44 people) - subperiosteal fractures; II group (58 people) - fractured body of the mandible with dislocation of the bone fragments (2 to 10 mm); III group (45 people) fractured body of the mandible follow by dislocation of the bone fragments (more than 10 mm). At hospitalization and in dynamics of treatment the following procedures took place: contact thermometry, reovasography, electrodiagnostics, study of the physiological condition of the mental nerve, determination of the temperature, pain and tactile sensitivity of the skin of the lower lip and the alveolar mucosa, and other methods. It is determined that the damage of the nerve is observed in all the cases where fractures are localized near the body of the mandibulae. The damages are systematized by the degree of severity (bruise, stretching, incomplete or full fracture) and the frequency of occurrence of every type of the fracture is reviled. The pathognomic tests are determined by mathematical method that are necessary for differentiating diagnostics of the degree of severity of th nerve damages and defining the effectiveness of the treatment. It is proven that the type of damage of the mental nerve (bruise, stretching, incomplete or full fracture) is depended on the dislocation of the bone fragments of the mandibulae with fractures that are localized in the body of the mandibulae. It is discovered, that in 37.5 % of the cases that are treated by osteosynthesis of the body of the mandible in patients with fractured mandibulae, the mental nerve was jammed between the fractured bone fragments. Modification of the osteosynthesis of the body of the mandibulae with creation of the site for deformed nerve is proposed. The paper describes clinical anatomy of the mental nerve in the cases with stretched nerve and incomplete fracture of a nerve. It presents developed schemes of conservative treatment of the patients with posttraumatic injuries according to severity of the injury.