Manifestation of traumatic disorders is often chracterised by reorganization or ossifcation of the TMJ hematoma, while the use of conservative therapy after TMJ traumatic injuries is often ineffective. The purpose of the preswent work was to study the effectiveness of arthrocentesis in the complex treatment of post-traumatic temporomandibular disorders. 24 patients with a history of mandibular condylar fractures underwent CT, ultrasound and MRI. TMJ arthrocentesis was performed under local anesthesia. After osteosynthesis, the number of patients with stage III according to Wilkes was up to 58.33% while, after splinting- 33.33%. The control ultrasound and MRI carried out 3-6 months after arthrocentesis showed no signs of hemarthrosis in 84.61% of patients with intra-articular disorders of the second degree, and also in 72.72% of patients with internal disorders of the third degree, the position and function of the articular disc being restored. Arthrocentesis with TMJ lavage is a minimally invasive surgical manipulation that has proven useful in temporomandibular disorders of traumatic origin, in particular after fractures of the articular process of the mandible. 

 Introduction. The main purpose of this research was to study the effectiveness of local fbrinolytic therapy in the rehabilitation of patients with traumatic injuries of the zygomatic-orbital complex. Materials and methods. Patients in the control group (15 persons) received in the postoperative period standard antibiotic therapy, and analgesic, antiinflammatory and anti-edematous therapy. Patients in the main group (17) received into the parabulbar tissues an additional injection of „Hemase” 5000 ME once a day, for 4-5 days. The effectiveness of the treatment was compared by determining the state of microcirculation, sensory sensitivity and level of enolase in the venous blood. Results and discussion. The general conjunctival index in the control group was 18.9 ± 1.2 points on the 7th day and 16.1 ± 1.8 points on the 14th day, and 15.7 ± 1.0 (p <0.05) and 11.7 ± 1.1 points (p <0.05), respectively, in the experimental one. The threshold of electrical excitability of the infraorbital nerve in patients of the control group on the 7th day was 68.4 ± 5.2 μA, while in the main one - 48.1 ± 5.3 μA (p <0,05). On day 14, the difference in the excitability threshold was even more pronounced: in the control - 52.9 ± 4.8 μA, in the main group- 33.2 ± 3.4 μA (p <0.05), with the index on the healthy side at 27.1 ± 1.9 μA. It was also found out that, in the control group, the level of enolase on both the 7th and 14th day exceeded the values obtained during the examination of patients in the main group: 24.5 ± 1.5 ng/ml to 19 , 4 ± 1.3 ng/ ml and 15.6 ± 1.4 ng/ml to 15.1 ± 1.5 ng/ml. Conclusions. The obtained data allowed stating that application of the proposed course of postoperative rehabilitation helps restore the conduction of nerve trunks, has an anti-edematous effect on the soft tissues of the infraorbital area and improves the hemodynamics of the suborbital artery and vein. 

 The aim: Scientifc work aims at determining the frequency and nature of disorders in psycho-emotional and autonomic systems in patients with combined trauma of the middle face. Materials and methods: Examination included 112 patients with combined trauma of the middle face.Their psycho-emotional state was assessed using the Impact of Event Scale (IES) and the Hospital Anxiety and Depression Scale (HADS). All patients were tested using questionnaires developed by Wayne A.M.. The Kerdo index was used to assess autonomic tone, while autonomic reactivity was determined using a Czermak-Gering carotid sinus test. Biochemical markers of stress - adrenocorticotropic hormone (ACTH), cortisol and anti-stress system - β-endorphins,and Garkavi L.Kh. adaptation index. Results: Patients with severe traumatic brain injury - 26.78%, and severe fractures of the facial bones - 48.21%. The consequence of traumatic events is the appearance of post-traumatic stress disorders in their mental function. Post-traumatic stress is also manifested at the hematological level in the characteristic stress reactions: the growth in the blood of stress markers - ACTH and cortisol and anti-stress factors, including β-endorphins
Conclusions: Middle facial injuries cause disorders of the psycho-emotional sphere, which are manifested in anxiety and depressive disorders. The post-traumatic period is accompanied by stress disorders, which are confrmed by hematological studies with a signifcant increase in stress markers (ACTH and cortisol) and an insignifcant increase in anti-stress factors in the blood. Insufcient stress-limiting function of the hypothalamic-pituitary system slows down the healing process and requires appropriate correction. 

 Introduction. Pathology of the temporomandibular joint (TMJ) is one of the urgent problems of modern maxillofacial surgery. In the early stages following cartilage damage, the loss of proteoglycans and collagen mesh disorder leads to functional disorders and diffculties in daily life. The aim of the present work was to diagnose the damage to cartilage and bone components of TMJ in traumatic fractures of the mandibular condylar process (MCP), and to study the correlation of magnetic resonance imaging (MRI) results and biochemical parameters in dynamics. Materials and methods. 22 males with traumatic condylar fractures were considered for the study. All patients underwent MRI upon admission, for 30 and 180 days after the treatment. To study the degree of bone and cartilage damage of TMJ, the levels of pyridinoline (PID) and deoxypyridolin (DPID) were determined by fluorescent immunoassay in the urine samples of patients, both before the treatment and after 21, 30 and 180 days. Results and discussion. Upon admission after MRI, only 22.73±9.14% of the subjects showed damaged joint surfaces while, on the 30th day - 31.82 ± 10.16% and on the 180 day - 40.91±10.73%. Biochemical studies performed in the frst days after injury showed an increased PID in all patients and increased levels of DPID in 20 patients, with average values of 150.82±10.73 and 37.00±2.22 nmol/mmol creatinine, respectively. Conclusions. MRI offers good analysis of all structures in joints, being able to detect damage to the articular cartilage only when present, and less suitable for detecting cartilage disorders as a disease stage, which precedes the lesion. Instead, tissue markers of PID and DPID bone destruction can be used to diagnose lesions of cartilage structures in very early stages and make predictions on the disease and its treatment.