颌骨外科内固定用钛板、钛钉需要常规取出吗?

Is it necessary to routinely remove the fixation plates following jaw surgery?

"颌骨外科"是指包括颌骨骨折、正颌外科和肿瘤术后骨缺损重建的学科。坚强(固)内固定主要用于骨折、截骨和植骨的功能性稳定固定,对其固定材料是否需要常规取出,国内外仍然存在争议。作者结合临床经验和国内外文献观点,对这一问题根据固定部位有无症状分为2种情况进行讨论。"有症状"钛板的取出原因主要是感染,钛板移位、断裂、外露,钛钉松动,面部外形隆突,植入体周围疼痛,牙种植义齿修复前的需要,温度变化敏感和患者的心理需要等,约占钛板固定患者的5%～29%。"无症状"钛板目前国内外大多数医师不主张常规取出。

Jaw surgery here refers to facial fracture reconstruction, orthoguathic surgery and bone reconstruction following tumor resection. Internal rigid fixation is used to maintain the above functional stability. There still exist controversies on the necessity of removal of the bone plates after bone healing. This paper discussed the bone plate removal as to two types： asymptomatic bone plates and symptomatic ones according to the authors＇ clinical experience and literature reviews. The reasons for the removal of symptomatic bone plates are infection, hardware migration, broken, exposure, screw loosening, palpability or prominent to the face, pain, dental implant, thermal sensitivity and patients＂ psychological reasons which account for 5% to 29% of patients experienced fixation treatment. Asymptomatic bone plates are not suggested to be removed regularly so far among most surgeons.