牙弓夹板颌间牵引联合坚强内固定术治疗面部粉碎性骨折疗效研究

Curative Effect of Intermaxillary Traction of Arch Bar Combined with Rigid Internal Fixation on Patients with Facial Comminuted Fractures

目的:研究牙弓夹板颌间牵引联合坚强内固定术治疗面部粉碎性骨折的疗效。方法:选择2017年3月-2020年5月笔者医院收治的80例面部粉碎骨折患者,根据患者手术方法不同分为对照组(38例)和联合组(42例),其中对照组给予牙弓夹板颌间牵引术治疗,联合组给予牙弓夹板颌间牵引联合坚强内固定术治疗。比较两组患者手术效果以及恢复指标,手术前后牙周情况[菌斑指数(PI)、软垢指数(DI)和牙龈指数(GI)]以及面部美学,并评估两组安全性。结果:联合组手术有效率为97.62%,高于对照组的84.21%,差异有统计学意义(P<0.05);联合组患者住院时间、骨折愈合时间以及张口度恢复时间均显著低于对照组(P<0.05);术前两组患者PI、DI和GI水平比较差异无统计学意义(P>0.05),术后联合组上述指标水平显著高于对照组,差异有统计学意义(P<0.05);两组患者术后并发症发生率比较差异无统计学意义(P>0.05);术前两组患者外观满意度评分比较,差异无统计学意义(P>0.05),术后联合组评分显著高于对照组,差异有统计学意义(P<0.05)。结论:牙弓夹板颌间牵引术联合坚强内固定术应用于面部粉碎骨折患者,可有效提高手术效果,促进患者恢复,同时可减轻对患者牙周组织的影响,减少并发症,较好地满足患者面部美学需求。

Objective To study the curative effect of intermaxillary traction of arch bar combined with rigid internal fixation on patients with facial comminuted fractures.Methods A total of 80 patients with facial comminuted fractures who were admitted to the hospital from March 2017 to May 2020 were enrolled.According to different surgical methods,they were divided into control group(38 cases,intermaxillary traction of arch bar)and combination group(42 cases,intermaxillary traction of arch bar combined with rigid internal fixation). The surgical effects and recovery indexes, periodontal conditions [plaque index (PI), debris index (DI), gum index (GI)] and beauty before and after surgery were compared. And the safety of both groups was evaluated. Results The response rate of surgery in combination group was higher than that in control group (97.62% vs 84.21%),the difference was statistically significant(P <0.05).The hospitalization time, fracture healing time and recovery time of mouth opening in combination group were significantly shorter than those in control group (P <0.05). There were no significant differences in the levels of PI, DI and GI between the two groups before surgery (P>0.05), which were significantly higher in combination group than control group after surgery,the difference was statistically significant (P <0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P >0.05). There was no significant difference in the score of appearance satisfaction between the two groups before surgery (P >0.05), which was significantly higher in combination group than control group after surgery,the difference was statistically significant(P <0.05). Conclusion The application of intermaxillary traction of arch bar combined with rigid internal fixation in patients with facial comminuted fractures can effectively improve surgical effect, promote their recovery, decrease the effects on periodontal tissues, and reduce complications, which can better meet their demands for facial beauty.