Lamphier Jennifer, Ziccardi Vincent, Ruvo Anthony, Janel Malvin
Department of Oral and Maxillofacial Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103, USA.
J Oral Maxillofac Surg. 2003 Jul;61(7):745-9; discussion 749-50. doi: 10.1016/s0278-2391(03)00147-2.
In this study, we compared the complications associated with open and closed treatment of mandibular fractures in an urban teaching center over a 4-year period.
We conducted a retrospective review of mandibular fracture morbidity associated with treatment by the oral and maxillofacial surgery service between 1996 and 2000. A total of 721 fractures were recorded, with 594 fractures available for review. Perioperative and postoperative complications were assessed by reviewing patient charts, operative reports, and radiographs. Complications were classified by location, type of complication, and treatment modality. Standard statistical tests were used to assess differences between the groups.
Of the 594 fractures available for review, a total of 79 fractures were noted to have had a complication (13.3%). One hundred five complications were observed in the group of 79 fractures due to more than one complication being associated with a specific fracture (15.8%). Closed reductions accounted for the largest treatment group, representing 341 fractures with 26 complications (7.6%). Miniplate fixation was used in 97 cases, with 23 complications (23.7%). Mandibular plates with or without a superior border miniplate were used in 140 fractures, with 28 complications (20%). The most common complication was wound infection, which occurred in 35 fracture sites, followed by nonunion, which occurred at 30 sites.
In an urban area with a high prevalence of poor living conditions, substance abuse, and poor patient compliance, the treatment of mandibular fractures by closed reduction resulted in the least number of postoperative complications in all anatomic regions of the mandible. The mandibular angle fracture had the highest overall morbidity rate.
在本研究中，我们比较了在一个城市教学中心4年期间下颌骨骨折开放治疗与闭合治疗相关的并发症。
我们对1996年至2000年间口腔颌面外科服务治疗的下颌骨骨折发病率进行了回顾性研究。共记录了721例骨折，其中594例骨折可供审查。通过查阅患者病历、手术报告和X光片评估围手术期和术后并发症。并发症按部位、并发症类型和治疗方式分类。使用标准统计检验评估组间差异。
在可供审查的594例骨折中，共有79例骨折出现并发症（13.3%）。在79例骨折组中观察到105例并发症，因为特定骨折与不止一种并发症相关（15.8%）。闭合复位占最大治疗组，代表341例骨折，有26例并发症（7.6%）。微型钢板固定用于97例，有23例并发症（23.7%）。带或不带上颌缘微型钢板的下颌骨钢板用于140例骨折，有28例并发症（20%）。最常见的并发症是伤口感染，发生在35个骨折部位，其次是骨不连，发生在30个部位。
在生活条件差、药物滥用和患者依从性差的患病率较高的城市地区，下颌骨骨折的闭合复位治疗在下颌骨所有解剖区域导致的术后并发症最少。下颌角骨折的总体发病率最高。
