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Khirurgii

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Year 2021 Vol. 29 No 4

TRAUMATOLOGY AND ORTHOPEDICS

T.A. STUPINA, T.N. VARSEGOVA

PATHOMORPHOLOGIC CHARACTERISTICS OF PALMAR APONEUROSIS IN PATIENTS WITH DUPUYTREN’S CONTRACTURE AND VIRAL HEPATITIS

G.A.Ilizarov National Medical Research Centre
for Traumatology and Orthopedics of the Ministry of Health of Russia, Kurgan,
The Russian Federation

Objective. To establish pathomorphologic peculiarities of palmar aponeurosis in the patients with Dupuytren’s contracture and concomitant virus hepatitis B and C.
Methods. The data analysis of histomorphometric studies of the operation samples of 122 patients with Dupuytren’s contracture («Control» group, n=100) and Dupuytren’s contracture with virus hepatitis B and C («Hepatitis» group, n=22) were analyzed.
Results. In patients of the «Hepatitis» group, the content of adiposed tissue in the palmar aponeurosis was 40.9% less (p <0.01) than in the «Control» group, and the content of dense connective tissue was 18.9% higher (p <0, 05). In all patients, arteries with the diameter up to 150 µm prevailed in the palmar aponeurosis, but in the «Hepatitis» group their percentage was reduced by 20%, with higher proportions of vessels with the diameter of 150–450 µm and the absence or recalibration of the largest arteries. In the «Control» group, the arteries had diameters from 50 to 660 µm, in the «Hepatitis» group they did not exceed 370 µm. Vessels less than 300 µm in diameter in both groups had comparable values of the Kernogan’s index. Arteries with a diameter of more than 300 microns in the «Hepatitis» group had higher values of the Kernogan’s index, which indicated a low conductance capacity compared to the vessels in the «Control» group. Most of the nerve trunks of the palmar aponeurosis in the patients of «Hepatitis» group showed signs of necrobiotic changes, i.e. fibrotic or swollen perineurium, with inflammatory cell infiltration, sometimes lost lamellar structure, and nerve fibers with signs of Wallerian degeneration.
Conclusion. Obtained histomorphometric data of the tissue composition of palmar fascial fibromatosis, less amount of adiposed tissue and higher amount of dense connective one and more pronounced disorder of hemodynamics and innervation of the palmar aponeurosis in the group with concomitant virus hepatitis indicate significant effect of the liver pathology on the progression of the disease.

Keywords: Dupuytren’s contracture, viral hepatitis, palmar aponeurosis, tissue composition, arteries, nerve fibers, pathomorphology
p. 454-461 of the original issue
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Address for correspondence:
640014, Russian Federation,
Kurgan, M.Ulyanova Str., 6,
G.A. Ilizarov National Medical Research
Centre for Traumatology and Orthopedics
of the Ministry of Health of Russia,
tel. +7 905 850-67-89,
e-mail: StupinaSTA@mail.ru,
Stupina Tatyana A.
Information about the authors:
Stupina Tatyana A., MD(Biol.), Leading Researcher of the Morphology Laboratory, G.A.Ilizarov National Medical Research Centre for Traumatology and Orthopedics of the Ministry of Health of Russia, Kurgan, Russian Federation.
https://orcid.org/0000-0003-3434-0372.
Varsegova Tatyana N., PhD(Biol.), Senior Researcher of the Morphology Laboratory, G.A.Ilizarov National Medical Research Centre for Traumatology and Orthopedics of the Ministry of Health of Russia, Kurgan, Russian Federation.
https://orcid.org/0000-0001-5430-2045
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