可吸收钉板在创伤性上颌骨骨折复位内固定手术中的应用

Application of Absorbable Nail Plate in the Reduction and Internal Fixation of Traumatic Maxillary Fracture

目的探讨创伤性上颌骨骨折患者复位内固定手术中采用可吸收钉板的效果。方法采用单中心临床随机试验,选取2017年6月至2022年6月在河南科技大学第一附属医院口腔科接受手术治疗的62例创伤性上颌骨骨折患者进行研究,其中31例患者接受金属钛板钛钉内固定系统治疗(钛板组)、另外31例患者接受可吸收钉板内固定治疗(可吸收钉板组),对比两组患者的手术前后颌面部对称性参数、颌面部功能、临床疗效、手术并发症。结果术前,可吸收钉板组和钛板组患者的颌面部对称性参数差异无统计学意义(P>0.05);术后12周,两组患者的面部不对称性指数降低(P<0.05),但组间差异无统计学意义(P>0.05)。术前,可吸收钉板组和钛板组患者的咀嚼功能、开口功能、颌面部评分差异无统计学意义(P>0.05);术后12周,两组上述评分降低(P<0.05),且可吸收钉板组评分低于钛板组(P<0.05)。术后可吸收钉板组患者的总体治疗效果优于钛板组(P<0.05)。可吸收钉板组和钛板组患者并发症差异无统计学意义(P>0.05)。结论可吸收钉板内固定能通过牢固的内固定达到恢复颌面部对称性的效果,更有利于患者术后颌面部功能的恢复。

Objective To explore the therapeutic effect of using absorbable nail plates in reduction and internal fixation surgery for patients with traumatic maxillary fractures.Methods A single center randomized clinical trial was conducted to select 62 patients with traumatic maxillofacial fractures who underwent surgical treatment in Stomatology Department of the Second Affiliated Hospital of Henan University of Science and Technology from June 2016 to June 2022.Among them,31 patients were treated with a metal titanium plate and titanium nail internal fixation system(titanium plate group),and the other 31 patients were treated with absorbable nail plate internal fixation(absorbable nail plate group).The symmetry parameters of the maxillofacial region,maxillofacial function,clinical efficacy and surgical complications were compared.Results There were no statistically differences in the maxillofacial symmetry parameters between the absorbable nail plate group and the titanium plate group before surgery(P>0.05).At 12 weeks after surgery,the facial asymmetry index of both groups of patients decreased(P<0.05),but the difference between the groups was not statistically significant(P>0.05).Before surgery,there were no statistically differences in the chewing function,opening function,and maxillofacial score between the absorbable nail plate group and the titanium plate group(P>0.05).At 12 weeks after surgery,the above scores decreased in both groups(P<0.05),and the score of the absorbable nail plate group was lower than that of the titanium plate group(P<0.05).The overall treatment effect of the postoperative absorbable nail plate group was better than that of the titanium plate group(P<0.05).There was no statistically difference in complications between the absorbable nail plate group and the titanium plate group(P>0.05).Conclusion Absorbable nail plate internal fixation can effectively restore maxillofacial symmetry through firm internal fixation,and is more conducive to postoperative recovery of maxillofacial function.