Histopathological changes and correlations of the morphological values of limb muscle status and clinical data in patients with the consequences of innervation traumatic disorders

Purpose. To reveal correlations between the manifestations of atrophic, substitutive, and reorganization processes in muscles, as well as between muscle structural changes and some clinical data on the basis of studying the qualitative-and-semi-quantitative pathological changes and their manifestation degree in skeletal muscle bioptates of patients with the consequences of limb nerve injury. Materials and Methods. 74 incision bioptates and the data of clinical examinations of 62 patients with the consequences of injuries of upper and lower limb nerves of different duration served as the material for the work. The following clinical data were taken into consideration: patients’ age at the time of injury; total duration of injury, the integral index of muscle functional state, as well as the morphological data were considered: a degree of muscle atrophy, a degree of type-grouping manifestation, and a degree of muscle fiber (MF) replacement by fibrofatty tissue. Correlations between clinical and morphological data investigated with calculating the coefficient of association, determining its parameter, the sign and degree of reliability. Results. The degree of developing muscle pathological changes for the consequences of limb nerve injury can vary widely thereby reflecting both the heterogeneity of the initial parameters of nerve injury, and different rates of developing atrophic, dystrophic, substitutive, regenerative, and reorganization processes, but the degree of these changes, in most cases, reaches moderate or significant manifestation in the long-term periods. A complex set of these changes in muscle causes a certain degree of its structural-and-functional insufficiency. Conclusion. The results of correlation analysis of the relationships between the clinical data and morphological parameters of innervation disorder manifestations in muscle bioptates evidence of the fact that the relationship parameters for “morphology - morphology” and “clinical picture - morphology” analogous pairs for the upper and lower limbs somewhat differ. The morphological parameters of the upper limb muscle status show a stronger relationship between each other comparing with the analogous parameters of the lower limb muscles, however, the relationship between "MF hypo-grouping МВ" and "MF replacement by fibrofatty tissue" parameters in the upper limb muscles is very weak.