MEDICO-LEGAL APPLICATIONS OF FRACTURE HEMATOMA: REVIEW.

This review aimed to elucidate the critical role of fracture hematoma in forensic medicine, with a specific focus on its utility in differentiating antemortem from postmortem fractures. The study seeks to provide a comprehensive synthesis of current knowledge on the subject, highlighting the biological and medico-legal implications of fracture hematoma analysis in forensic investigations. A systematic review of literature was conducted, encompassing various scientific databases including PubMed, Scopus, and Web of Science, focusing on studies published from 2000 to 2024. The search employed keywords such as "fracture hematoma," "antemortem fractures," "perimortem fractures" and "postmortem fractures," among others, to explore relevant data. Selected studies were scrutinized based on their relevance, the presence of substantial data on fracture hematoma, and their contribution to forensic analysis. The review underscores the significance of fracture hematoma as an indicator of antemortem injuries, revealing that active blood circulation at the time of injury facilitates hematoma formation. Detailed analyses within the selected studies illustrate the interplay of cellular and molecular dynamics within fracture hematomas, emphasizing the roles of cytokines, particularly IL-6, and cellular constituents in the healing process. Fracture hematoma analysis emerges as a vital forensic tool in establishing the vitality of bone fractures, enhancing the accuracy of forensic assessments. However, the review also acknowledges the challenges posed by individual healing variability and postmortem changes, suggesting a need for further research to refine the interpretative frameworks used in forensic hematoma analysis.

The spectrum of hemispheral cortex lesions in intrauterine alcoholic intoxication.

Aim of the study was to examine the specific morphological changes of brain cortex in fetal alcoholic intoxication model. The latter was performed in male and female animals by substituting water with 15% ethyl alcohol during 1 month period, which was followed by putting pregnant females on alcohol of the same concentration for the duration of the whole period of pregnancy (21 days). 24 experimental and 10 control (intact) animals were subjected to study overall. The study material applied the samples of brain convexital cortex from foetus and newborn rats. Paraffin-embedded slices (films) were dyed by the method of Nissle and hematoxylin eosin. After immersion fixation in 2.5% glutaraldehyde and 1% osmium acid solutions followed by double contrasting, the ultrathin slices were studied in the electron microscope Tesla BS 500. Macroscopic study demonstrated the hyperemia of pia with partial incorporation, different types of neuroorganogenesis disturbance, also, leptomeningeal heterotopia and microcephaly in 6 cases from 24 (25%) in the experimental group. Morphology of cortical damage to fetal brain in alcoholic intoxication was demonstrated by progressive massive destruction of neuronal mitochondria, involutional changes in dendrites and their processes and glial proliferation, which possibly account for the structural basis of energetic and informational deficit in neurons. Acquired data may be extrapolated on human model of alcoholic embryopathy with subsequent cognitive problems.

[Clinical-morphological aspects of osteochondroma of long bones].

Clinical-morphological aspects of osteochondroma reflect the rate of cancer growth and its prognosis. Verification of bones forms is required to diagnose exostosis. Revealed forms of osteochondroma differ by clinical course which need different surgical approach. The aim of the article was to propose new surgical technique to treat osteochondroma. 71 patients with osteochondroma were examined by clinical and radiological methods. The samples were investigated by histological, histostereometric, morphometric and immunohistochemical methods (using monoclonal antibodies ki-67). It is concluded, that the growth rate of exostosis depends on: location of the tumor; the structural architecture of the cartilage; enchondral ossifications in tumor. The active and passive stages of osteochondromas in long bones are depicted.

[Morphological peculiarities of consolidation of experimental mandible fractures by osteosynthesis using Kollapan and retabolil].

The Purpose of the research was to study in the experiment morphological particularities of mandible fracture consolidation by osteosynthesis using Kollapan and Retabolil. The experiments were carried out on sexually matured rabbits. In the first series of the experiments (the control group), mandibula bones fracture was prototyped lower, whereas bone fragments were fixed by miniplate. In the second series of the experiments (the study group) bone fragments were bolted by the above mentioned way but diastase between bone fragments was filled by Kollapan granules, containing klaforan, and animals were intramuscularly anabolic material (the retabolil 0.4 mg/kg). On the 3-d and 15-th days, as well as, after 1 and 2 months after operation observing all corresponding rules, animals were killed and patologico-anatomic study of jaw bone was carried out. The analysis of the results showed that in experimental animals both in the control and the study groups reparative regeneration of bone tissues runs with the formation of periosteum and intermedium regenerator, at the same time consolidation of the bone defect in the main group occurs earlier than in the control group. The Results of the studies point out that Retabolil under osteosynthesis is an osteoinductive material and Kollapan, having osteoinductive, osteoconductive, and osteoprotective characteristics, promotes speeding of the process of jaw bones fracture consolidation.

[Peculiarities of mandible fracture consolidation while applying different methods of treatment].

Purpose of the study was the photodensitometrical estimation of the efficiency of using kolapan granules in combination with the retabolil injection, during the osteosinthesis in the cases of mandible fracture. The operative treatment of patients was realized at the second day following the trauma. The Patients were divided into three groups: 1-st group (20 patients), where fixing was done by intermaxillar Tigerstadt device, in the 2-nd group (20 patients) osteosinthesis was carried out by the titanium miniplates ("LIM"), while in the 3-rd group (20 patients) - osteosinthesis with the use of the same titanium miniplates ("LIM"), kollapan granules (the company "Intermedapatit") and intermuscular injection of retabolil (the company "Gedeon Richter") - 50mg (5%) was performed. Radiography was carried out in patients in standardized conditions, at the day of operations, at the 1-st, 4-th and 24-th weeks after trauma. From the gained results the significant advantage of osteosinthesis in combination with filling the defect by Kollapan granules and usage of retabolil in comparison with the intermaxillar fixation and usual osteosinthesis is obviously seen. The process of osteogenesis under such treatment is significantly faster.

[Features of regeneration of joint cartilage during osteoarthritis].

In order to define the features of regeneration of joint cartilage during osteoarthritis, morphological study of surgical material, obtained from 50 patients, has been performed with the help of histological, histochemical and morphometric methods. In the joint cartilage, alongside with the alteration, there is also the cellular regeneration expressing in the intensive proliferation of cartilaginous cells. However, maturing of the regenerated cells proceeds defectively and consequently regenerate loses ability to be differentiated in hyaline, joint cartilage that specifies the phase of differentiation. Hence, the specified process should be qualified as not reparation, but as a pathological regeneration. Cartilaginous regenerate is not capable to carry out amortization and protective functions of an articulate cartilage and is exposed to secondary alteration. The last, in turn, aggravates arthroses changes and causes progressing disease.