Iatrou I, Samaras C, Theologie-Lygidakis N
Department of Oral and Maxillofacial Surgery, University of Athens, Greece.
J Craniomaxillofac Surg. 1998 Dec;26(6):400-4. doi: 10.1016/s1010-5182(98)80075-9.
Our 8 years experience of treating fractures of the edentulous mandible by miniplate osteosynthesis, is discussed. Forty patients (31 men and 9 women) aged 37 to 86 years (mean: 64.6 years, SD: +/- 14.07) with 67 fracture sites were treated. The surgical approach was mainly intraoral (37 out of 40 patients) without the use of intermaxillary fixation. The postoperative clinical and radiological findings are reported and discussed. The advantages of the method are of great importance since immediate postoperative opening of the mouth is permitted, as the fractured bones are anatomically stabilized by means of titanium miniplates and screws. Our results were felt to be satisfactory, with a reoperation rate of only 3.9% (two out of 51 operated fracture sites, 16 condylar fractures were treated conservatively). This allows us to propose intraoral miniplate osteosynthesis as a routine method of treatment in cases of edentulous mandibular fractures which are mainly seen in elderly people.
本文讨论了我们采用微型钢板内固定治疗无牙下颌骨骨折8年的经验。共治疗了40例患者(31名男性和9名女性),年龄在37至86岁之间(平均64.6岁,标准差:±14.07),共有67处骨折部位。手术入路主要为口内入路(40例患者中有37例),不使用颌间固定。报告并讨论了术后的临床和影像学结果。该方法的优点非常重要,因为术后可立即开口,骨折部位通过钛微型钢板和螺钉实现解剖学稳定。我们的结果令人满意,再手术率仅为3.9%(51处手术治疗的骨折部位中有2处,16例髁突骨折采用保守治疗)。这使我们能够提出,对于主要见于老年人的无牙下颌骨骨折,口内微型钢板内固定可作为一种常规治疗方法。