下颌角不稳定性骨折不同治疗方法的临床效果分析

Evaluation of the treatment of unfavourable mandibular angle fracture by internal fixation via two different approaches

目的：探讨口内或口外2种路径进行微型钛板固定术治疗下颌角不稳定性骨折的临床效果。方法：通过口内（n=20）和口外（n=26）路径对46例下颌角不稳定性骨折进行微型钛板固定术,术后观察治疗效果。结果：口外组有2例切口感染,其中1例发展为骨髓炎经过拔牙及取出钛板后愈合;口内组有2例口内切口感染,经过局部冲洗填碘仿纱条后愈合;2组其余病例术后切口均I期愈合。经过3-12个月随访,2组病例张口度大于35 mm,无咬合紊乱,骨折对位良好,无移位。口外组病例均留有瘢痕。结论：2种方法治疗下颌角不稳定性骨折,均达到稳定固定的效果。

Objective：To evaluation of the treatment of unfavourable mandibular angle fracture by internal fixation with two different approachs.Methods：46 patients with unfavourable mandibular angle fracture were treated by internal fixation with titanium miniplate through transoral approach group（n = 20） and extraoral approach group（n =26） respectively.Postoperative clinical and radiological data including wound healing,difficulty in function and malocclusion were analysed 10 days,3 months and 6 months after operation.Results：Postoperative infection occurred in 2 cases in extraoral group,and 1 of them developed as ostomylitis which recovered gradually in 1 year.Surgical site infection was observed in 2 cases in transoral approach group,which was resolved with appropriate course of antibiotics and wound care.Conclusion：Unfavourable mandibular angle fracture can be effectively treated by titanium miniplate via intraoral or extraoral approach.