口内外联合切口坚强内固定术在非利型下颌角骨折中的应用

The application of the clinical application of miniplate fixation with internal and external combined oral for unfavorable mandibular angle fractures

目的探讨口内外联合切口坚强内固定术在非利型下颌角骨折中应用的临床疗效。方法 32例非利型下颌角骨折中采用口内切口外斜线张力带固定与口外切口下颌骨下缘钛板固定,对术后感染、术后张口情况、咬合关系、颞下颌关节检查、口腔全景片检查及面部美观测评等进行分析。结果 32例患者中除1例因骨折线上阻生智齿术中未拔除,术后出现感染,经给予拔除阻生智齿及抗感染治疗后愈合。1例出现轻度咬合关系紊乱,经给予颌间牵引固定及局部调颌后,咬合关系恢复正常,其余30例下颌骨的外形与生理功能得到较好地恢复。结论口内切口外斜线张力带固定与口外切口下颌骨下缘钛板固定在非利型下颌角骨折中具有术后颌下皮肤瘢痕小,固定稳定,减少感染,利于咬合关系恢复及面容评价良好,还有无需特殊器械操作的优点。

Objective To investigate the clinical application of miniplate fixation with internal and external combined oral for unfavorable mandibular angle fractures.Methods Miniplate rigid internal fixation technique as tension band,mandible margin was used in all 32 cases of unfavorable mandibular angle fractures.Data from 32 patients treated were analysed in terms of postoperation infection,mouth opening limitation,abnormality of TMJ,malocclusion,panoramic X-ray film.Results Among 32 patients,there was 1 example of wound infection because the third molars on the line of fracture was not pulled out,,1 example of malocclusion,and 30 cases were completely repaired.Both mandibular appearance and physiological functions were restored satisfactorily.Conclusion Miniplate rigid internal fixation technique used as tension band,mandible margin is a good method with small scars,stable retention,reduction of infection,and good for postoperative occlusion and appearance in the treatment of mandible.