坚硬内固定在下颌骨手术中的应用

The Application of Rigid Internal Fixation to Mandible Operation

目的 提高坚硬内固定在口腔颌面外科的临床应用水平 ,减少并发症。方法 2 1例下颌骨骨折和肿瘤切除术后骨缺损或骨连续性中断的病人分别采用经穿颊器口内内固定术、接骨板定位后骨截开或截除内固定术。结果 术后外形两侧基本对称 ,无明显功能障碍。 1例近期创口发生感染 ,2例远期螺钉松动而导致局部感染。结论 经穿颊器行下颌骨骨折内固定避免口外切口而有利于美观 ;接骨板塑形定位后再行下颌骨截开或截除的内固定术易维持术前牙合关系和颌骨的外形 。

Objective To improve clinical application of rigid internal fixation to oral and maxillofacial surgery and reduce the complication.Methods 21 patients with mandible fracture,defect after tumor ablation and discintinuity were respectively treated with rigid internal fixation under transbuccal instrument,and pre bending and positioning of reconstruction plate before osteotomy or bone resection.Results Moderate symmetry in bilateral mandible was obtained without any dysfunction.The incision infection occured in one case in shortterm,and the loosing of screw and local infection occurred in other two patients in long term. Conclusion Rigid internal fixation of mandible fracture with transbuccal instrument avoided extra oral approach and was beneficial to facial aesthetics.The internal fixation with pre bending and positioning of reconstruction plate before osteotomy or bone resection could conserve preoperative occlusion relation and mandible shape,and restore satisfactory appearance and function.