摘要
目的 探讨下颌角骨折小型接骨板张力带固定的临床可行性。方法 研究组 2 7例 2 8侧下颌角骨折行小型接骨板张力带固定 ,对照组 19例行下颌骨下缘固定 ,两组的不利型骨折比例分别为 82 %和 95 % ,严重移位骨折比例 2 5 %和 85 % ,术前感染比例 0和 2 5 % ,骨折复位同期拔牙比例5 5 %和 33% ,病例复查率 89%和 79% ,平均复查期 36周和 31周 ,经临床及X线检查进行比较分析。结果 研究组和对照组的术后感染率分别为 10 71%和 5 0 0 % ,干扰率 7 40 %和 5 2 6 % ,张口受限率 14 81%和 10 5 3% ,创伤性关节炎发生率 11 11%和 2 1 0 5 %。张力带固定组 2 1 43%的骨折术后出现下颌骨下缘分离或再移位 ,同时伴外骨痂形成 ;下颌下缘固定组 10 %的骨折存在复位固定缺陷 ,分别发生在未设张力带的加压固定和两个小型接骨板并行固定。结论 下颌角骨折采用小型接骨板张力带固定的稳定性不足 ,只适用于有利型和轻度移位的骨折 ,不利型和严重移位的骨折应增加下缘固定。稳定性不足和复位同期拔牙是术后感染的可能原因。
Objective To investigate the clinical application of miniplate as tension-band in fixation of mandibular angle fractures Methods The miniplate fixation as tension-band was used in 27 cases and 28 sites of mandibular angle fracture, another 19 cases of mandibualr angle fracture involving 20 sites were fixed at the lower border by using universal plate(14 sites), compression plate (4 sites) and double miniplate (2 sites) The tension-band fixation group contained: unfavorable fracture line 82%, serious displacement 25% , extration of tooth simultaneously at reduction 55% In lower border fixation group, there were 95% of patients with unfavorable fracture line, 85% had serious displacement ,and 33% had tooth removed The follw-up rate was 89% with a mean period of 36 weeks in the tension-band group and 79% with a mean period of 31 weeks in lower border group Results Infection occured in 10 71% of tension-band group and 5% of lower border group, and mild malocclusion appeared in 7 4% and 5 26% respectively Additionally, 21 43% of the tension-band group had a healing gap at lower border Conclusions The use of miniplate for the tension-band fixation is effective for the favorable and slightly displaced mandibular angle fractures, the augmentation of fixation at lower border was necessary for unfavorable and seriously displaced fractures
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2000年第5期340-342,共3页
Chinese Journal of Stomatology
