颅骨骨折465例治疗体会

Clinical Experience in Treatment of 465 Cases of Jaw Fracture

目的：总结五年颌骨骨折治疗体会，探讨有关问题．方法：选用１９９５年３月至２０００年３月治疗的颌骨骨折４６５例，男３４８例、女１１７例．根据就诊时间早晚、致伤原因、骨折部位及分类，治疗方法选择进行总结．结果：治疗有效率９８．９２％，行紧急气管切开术４５例，抗体克１２例，手术切开复位骨间固定２８４例，手法或牵引复位外固定１８１例，术后感染骨延迟愈合 ８例（ １．７％）合并颅脑损伤死亡 ５例（ １．０８％）．结论：①排除颅脑及内脏损伤，保证无窒息、休克发生，通过临床表现确诊骨折类型．②要使骨折片尽早复位，应用坚固内固定技术保证骨块不再移位，恢复伤前咬合关系，软组织要严密缝合．③正确地运用正颌外科技术，使陈旧性骨折达到三维立体方向复位．

Objective: To summarize the clinical experience in the treatment of jaw fracture and explore some related problems. Methods: 465.cases of jaw fracture were studied according to time when the patients came to hospital, causes, sites, classifications and methods. Results' Urgent tracheotomy was performed in 45 cases, antishock therapy in 12 cases, open reduction and internal maxillary fixation in 284 cases, manual reduction or traction reduction and external fixation in 181 cases. The effective fate was 98.92%. Delayed healing resulting from postoperative infection happened in & cases (l .72%). Death resulting from cerebral wound took place in 5 cases (l.08%). Conclusions: Confirmed diagnosis could be obtained from the clinical manifestation on condition that there is no cerebral or viscera wounds, asphyxia or shock. The strong and effective internal fixation to the jaw and close suture to soft tissue should be necessary to make the reduction of jaw fracture earlier. The reduction of old fracture could be acquired in 3-D by the application of orthognathic surgery.