Sebov V. Prediction and prevention of traumatic osteomyelitis in patients with fractures of the lower jaw

This thesis work is devoted to the problem of promotion of treatment efficiency for traumatic fractures of the lower jawbone and reduction of the frequency of post-traumatic complications. A result of research was established that the most informative for predicting the chance of developing traumatic osteomyelitis are the following indicators: troubles fracture, erythrocyte sedimentation rate, leukocyte index of intoxication test with tetanus toxoid, the rate of vascular tone and rheographic index. Based on these data a mathematical model to predict the fracture traumatic osteomyelitis of the lower-jawbone. Its predictive value confirmed in 77.8% of cases. Use of this model allows us to identify patients with a predisposition to the development of inflammatory complications, and after dividing them into risk groups, to provide preventive-curative measures, individually in each group depending on the result of the prediction. The study of hemodynamics of patients with lower-jawbone fractures revealed that poor circulation in the zone of injury is caused not only by damage of the vascular anatomy, but also by the change of the functional nature, particularly by the vasoconstriction. Research has shown that in order to normalize blood flow in damaged tissue the use of block of peripheral sensory and sympathetic fibers is possible. The data of rheography confirmed that trigeminy-sympathic blockade contribute to the normali-zation of blood circulation in the zone of injury (the increase of the amplitude charac-teristics of rheogram in average for 66.9% and reduced vascular tone for 34.8%). The use of the offered set of preventive measures for patients with lower-jaw-bone fractures reduced frequency of development of traumatic osteomyelitis in 2.6 times.