口内入路与口外入路治疗下颌角骨折的疗效比较

Treatment of mandibular angle fracture through intraoral and extraoral approach: a comparative study

目的:探讨口内入路与口外入路治疗下颌角骨折的临床疗效。方法 :对2008年1月—2014年12月收治的46例下颌角骨折患者进行回顾分析,患者分为2组,第1组22例患者采用口内入路,用1块宽2.0 mm小钛板复位固定。第2组24例患者采用常规下颌下入路,用2块2.0 mm钛板复位固定。术后均行颌间弹力牵引3周。采用SPSS 13.0软件包对数据进行统计学分析。结果:术后3周第1组患者无感染及口角歪斜发生;第2组患者5例出现感染,3例出现暂时性口角歪斜。3个月后复诊,第1组患者切口愈合良好,骨折断端愈合良好,咬合关系恢复良好,开口度正常;第2组患者3例出现骨折愈合不良,再次手术取出钛板,咬合关系欠佳。结论:对于下颌角骨折,采用口内入路复位固定同样可以达到良好的治疗效果;与口外常规下颌下切口相比,口内切口创伤小,美观,不会损伤面神经,术后并发症少,手术成功率高。

PURPOSE： To compare the clinical effects of mandibular angle fracture surgery through intraoral and extraoral approach. METHODS： From January 2008 to December 2014, 46 patients with mandibular angle fracture were retrospectively recruited in this study. An intraoral approach was used in 22 cases as group 1 in whom the fractures were fixed by one titanium miniplate alone, the others through an extraoral approach as group 2 in whom the fractures were fixed by two plates. Intermaxillary traction was used in all patients for 3 weeks following the operation. The data was collected in MS Excel 2003 and further analyzed by SPSS13.0 software package. RESULTS： The wound healing was in uneventful group 1, no complication occurred 3 weeks later. On the contrary, 5 cases with postoperative infection and 3 cases with temporary weakness of facial nerve were observed in the group 2. Three months later, postoperative panoramic radiographs showed mandible fractures healed well in group 1; while in group 2, three cases complained of unhealed fractures and unsatisfactory occlusion. CONCLUSIONS： Compared with extraoral approach to manage mandibular angle fracture with 2 miniplates, one miniplate through intraoral approach can provide better outcomes.