Wheatley M J, Meltzer T R
Department of Surgery, Division of Plastic and Reconstructive Surgery, Oregon Health Sciences University, Portland Veterans Administration Medical Center, Portland, Oregon, USA.
J Craniomaxillofac Trauma. 1997 Spring;3(1):46-51.
Both miniplate and larger fracture plate fixation techniques have been utilized successfully in the treatment of mandibular fractures. Parasymphyseal fractures which occur in conjunction with bilateral subcondylar fractures, however, represent a special fracture pattern that is not well managed with miniplate fixation. Miniplates do not have the tensile strength to resist the strong, muscular-deforming forces that act on these fractures. This fracture pattern is best managed with anatomic symphyseal reduction and internal fixation with a 2.7 mm mandibular fracture plate and a 2.0 mm tension band plate. The subcondylar fractures can then be managed with either intermaxillary fixation or open reduction. This approach provides good functional results and can prevent late complications.
小型接骨板和较大的骨折接骨板固定技术均已成功应用于下颌骨骨折的治疗。然而，与双侧髁突下骨折同时发生的下颌骨颏孔区骨折是一种特殊的骨折类型，小型接骨板固定对此处理效果不佳。小型接骨板没有足够的抗张强度来抵抗作用于这些骨折的强大肌肉变形力。这种骨折类型最好采用解剖复位，并用2.7毫米下颌骨骨折接骨板和2.0毫米张力带接骨板进行内固定。然后，髁突下骨折可采用颌间固定或切开复位处理。这种方法能取得良好的功能效果，并可预防晚期并发症。
