重建板坚强内固定治疗下颌骨粉碎性骨折45例报告

Treatment of mandible comminuted fracture by open reduction and rigid internal fixation of reconstructive plate

目的:总结下颌骨粉碎性骨折的手术治疗方法。方法:对45例下颌骨粉碎性骨折采用口内或口外广泛切开,充分暴露骨折区全貌,并进行下颌骨的解剖复位,采用重建板坚强内固定。结果:45例下颌骨粉碎性骨折术后44例伤口一期愈合,骨折复位愈合良好,咬合关系恢复良好,张口度正常;1例术后下颌前庭沟黏膜处钛板小部分外露,经局部治疗,保持口腔卫生、预防感染,8个月后手术取出固定钛板螺钉,骨折处对位愈合良好,咬合关系良好,无骨感染、骨不连发生。结论:广泛切开能凊楚显露下颌骨粉碎性骨折的骨折线全貌,方便在直视下准确复位固定各骨折块、恢复下颌骨的解剖结构,获得良好的咬合关系。重建板固定骨折具有良好的稳定性和可靠性,适用于下颌骨粉碎性骨折。

Objective：To discuss the method of surgical treatment of mandible comminuted fracture.Method：45 cases of mandible comminuted fracture were treated by intraoral or extraoral open reduction and rigid internal fixation of reconstructive plate.Result：It brings sound results of reduction and healing after surgery under healing by first intention for the 44 cases of mandible comminuted fracture.The occlusion recovery of the 44 cases was satisfied,and the mouth opening was quite normal.But for 1 case,a small part of the titanium plate on the mucous of the vestibular groove on the left of the mandible was exposed after surgery.By keeping local cleaning and preventing infection,the fixation screw of the titanium plate was taken out after 8 months through surgical operation.As a result,the fracture healing and occlusion recovery were in good condition,without any infection of bone or nonunion.Conclusion：The fracture line of the mandible comminuted fracture can be fully observed under open reduction.Consequently,each fracture can be accurately reduced and fixed,and the anatomic structure of the mandible can be well recovered,so that excellent occlusion recovery can be achieved.The reconstructive plate fixation of fracture enjoys excellent stability and reliability,applicable to the treatment of mandible comminuted fracture.