小型钛板坚强内固定治疗下颌骨骨折的临床经验

Clinical Effects of Titanium Miniplate Osteosynthesis on Mandibular Fracture

目的探讨小型钛板坚强内固定治疗下颌骨骨折的治疗效果。方法回顾分析273例下颌骨骨折患者应用小型钛板坚强内固定的治疗效果及随访结果,总结有关处理经验和教训。结果 273例中269例患者术后伤口Ⅰ期愈合,1例伤口感染、3例伤口延期愈合。主要并发症包括术后咬合关系紊乱10例,骨折愈合不良致骨折再错位1例,重度开口困难1例,手术造成牙根损伤3例、颏神经损伤1例。术后3个月作疗效评价。Ⅰ级:伤口愈合好,骨折端对位好无错位愈合,咬合关系正常,无开口困难等功能障碍;Ⅱ级:伤口愈合良好,骨折端无错位愈合或轻微错位,咬合关系基本正常,无或轻度开口功能障碍;Ⅲ级:伤口感染骨折断端不愈合,骨折端复位差错位愈合,咬合关系紊乱,有重度开口困难等功能障碍;3个等级分别为Ⅰ级占91.21%(249/273),Ⅱ级占6.96%(19/273),Ⅲ级占1.83%(5/273)。结论下颌骨骨折应用小型钛板坚强内固定治疗效果可靠,通过完善的围手术期处理,可以达到较好的临床疗效。

Objective To discuss the clinical effects of titanium miniplate osteosynthesis on the mandibular fracture. Meth ods The outcomes and clinical data of 273 cases with titanium miniplate osteosynthesis for mandibular fracture were analyzed retrospectively. Results In these 273 cases, the operative incision of 269 cases were primary healing, 1 infection in the open wound and 3 delayed union. The main complications were malocclusions （ 10 cases）, severe trismus （ 1 case）, damage at the root of the teeth（ 3 cases） and injury of the nerves（ 1 case）. The treatment outcome were evaluated according to three classifications at 3 months after the operation, there were 249 cases belonging to I type, the excellent effect （91.21%） ;19 cases belonging to 11 type,the good effect（6.96% ） ;5 belonging to II type,the poor effect（ 1.83% ）. Conclusion The titanium miniplate osteosyn thesis is effective and reliable for mandibular fractures, and the enhanced perioperative management is helpful for the clinical ef fectiveness.