正颌外科技术及坚强内固定治疗陈旧性下颌骨骨折

Application orthognathic surgery and rigid internal fixation in mandibular old fractures

目的探讨陈旧性下颌骨骨折的治疗方法及临床疗效。方法 2010年4月-2013年3月采用正颌外科技术及坚强内固定治疗11例陈旧性下颌骨骨折。根据影像学资料进行模型外科、确定截骨部位及坚强内固定以恢复相对正常的咬合关系。术后根据X线检查结果确定骨折愈合情况,根据咬合关系、咬合力及颞下关节张口度等体征确定临床疗效。结果 11例术后均获随访,随访4~30月,平均13个月。术后6个月时X线提示骨折均愈合。10例咬合关系、咬合力及张口度良好。其中1例虽张口度及脸形良好,但咬合关节欠佳,内固定固定8个月后予正畸矫形后恢复良好。总体优良率达90.9%。结论正颌外科技术及坚强内固定为陈旧性下颌骨骨折提供二次解剖复位,对恢复正常的咬合关系、张闭口功能和颜面外形能提供可靠的保证。

Objective To investigate the clinical efficacy of treatment of mandibular old fractures.Method From April 2010 to May 2013,11 cases of mandibular old fractures were treated with Orthognathic surgery and rigid internal fixation.According to the imaging data,model of surgical,osteotomy site and rigid internal fixation were taken to restore normal occlusion.Fracture healing were evaluated by the X-ray and clinical efficacy by occlusion,bite force and joint mouth of the inferior temporal postoperatively.Result Fractures healed six months postoperatively by X-ray.Occlusion,bite force and infratemporal joint is good.One of them,although the degree of mouth and face shape were good,bite joints were poor,was treated by Orthodontics Orthotics after internal fixation for eight months.Overall excellent rate of the patients is 90.9%.Conclusion Orthognathic surgical techniques and rigid internal fixation of mandibular fractures can provide secondary anatomical reduction and get a reliable guarantee for restoration of normal occlusion,openclosed function and facial appearance.