Potter J, Ellis E
Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9109, USA.
J Oral Maxillofac Surg. 1999 Mar;57(3):288-92; discussion 292-3. doi: 10.1016/s0278-2391(99)90674-2.
This study evaluated the results in patients treated for fractures of the mandibular angle with a single, thin, malleable miniplate designed for use in the midface.
Forty-six patients with 51 fractures of the mandibular angle were treated by open reduction and internal fixation using one noncompression, thin, malleable miniplate and 1.3-mm self-threading screws placed through a transoral incision. No patient was placed into postsurgical maxillomandibular fixation. They were prospectively studied for complications.
Seven patients (15.2%) experienced complications. All were considered minor and did not require hospitalization. Three had asymptomatic fracture of the bone plate, but at the time of diagnosis the fracture had already healed and it required no treatment. Two patients had fracture of the bone plate with continued fracture mobility requiring maxillomandibular fixation. Three minor infections occurred requiring intraoral incision and drainage.
The use of this small bone plate for fractures of the angle of the mandible provided adequate fixation in most cases but was associated with an unacceptable incidence of plate fracture. However, the results also indicate that the fixation requirements for angle fractures is less than previously thought.
本研究评估了使用一种专为中面部设计的单一、薄且可塑形的微型钢板治疗下颌角骨折患者的结果。
46例下颌角骨折患者共51处骨折,通过经口切口采用一块非加压、薄且可塑形的微型钢板及1.3毫米自攻螺钉进行切开复位内固定治疗。所有患者术后均未进行颌间固定。对患者进行前瞻性并发症研究。
7例患者(15.2%)出现并发症。所有并发症均被认为轻微,无需住院治疗。3例患者骨板出现无症状骨折,但诊断时骨折已愈合,无需治疗。2例患者骨板骨折且骨折部位仍有活动,需要进行颌间固定。发生3例轻微感染,需要进行口内切开引流。
使用这种小型骨板治疗下颌角骨折在大多数情况下能提供足够的固定,但钢板骨折发生率令人难以接受。然而,结果也表明下颌角骨折的固定要求比之前认为的要低。