颌面部陈旧性、多发性骨折的治疗

Treatment of fracture of the maxillofacial skeleton

目的:总结5年颌面部陈旧性、多发性骨折治疗体会,探讨有关问题。方法:选用1997年1月至2001年12月治疗的颌面部陈旧性、多发性骨折278例,男171例、女107例。根据骨折类型,手术方法进行总结。结果:治疗有效率98.56%。全部采用手术切开复位骨间固定,169例(60.79%)再佐以颌间或颅颌固定进行加强。术后感染4例(1.44%),经大剂量抗生素应用后骨延迟愈合。术后咬合关系欠佳2例(0.72%),经正畸或修复矫治后效果满意。结论:①三维CT在颌面部陈旧性、多发性骨折治疗中具有指导作用。②正颌外科技术的成功应用使颌面部陈旧性、多发性骨折能够准确复位。③坚固内固定技术为颌面部陈旧性、多发性骨折治疗提供可靠保证。④颌面部发生陈旧性、多发性骨折后出现骨质缺损者主要依赖植骨进行修复和重建。

Objective： The purpose of this study was to discuss the treatment of fracture of the maxillofacial skeleton through the review of patients treated during a 5-year period. Method： We conducted a retrospective review of 278 patients from 1997 to 2001 and clarified the patients by the type of fracture and the methods of treatment. Results： 274 cases recovered after the operation. 169 cases （60.79%）of them undergone rigid intermaxillary fixation or craniomaxillofacial fixation after operation. 4 cases with infection after operation recovered after the use of antibiotic. 2 cases with malocclusion recovered after orthodontic treatment. Conclusion： ①Three-dimensional CT is important during diagnose and the treatment of maxillofacial skeleton. ②The introduction of orthognathic surgery makes the operation more precise. ③The method of rigid fixation makes treatment more reliable. ④The gape brought by the fracture should treated mainly with bone implant.