Ellis E, Karas N
Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9031.
J Oral Maxillofac Surg. 1992 Sep;50(9):958-63. doi: 10.1016/0278-2391(92)90055-5.
Thirty patients with 31 fractures of the mandibular angle were treated by open reduction and internal fixation using two mini dynamic compression plates with self-threading screws placed through a transoral incision with transbuccal trochar instrumentation. None of the patients were placed into postsurgical maxillomandibular fixation (MMF) or training elastics. Complications requiring secondary surgical intervention occurred in nine fractures (29%). Three were early infections requiring incision and drainage, removal of the hardware, and postoperative MMF. One was a nonunion with malocclusion requiring application of a more rigid bone plate. Five fractures developed late chronic swelling and low-grade infection requiring plate removal. Osseous union had occurred in these cases and no MMF was necessary. The use of two mini dynamic compression plates in the manner done in this study was found to be a relatively easy but unpredictable treatment for fractures of the mandibular angle.
30例下颌角31处骨折患者采用经口内切口、经颊穿刺套管器械置入两枚带自攻螺钉的微型动力加压钢板进行切开复位内固定治疗。所有患者术后均未行颌间固定（MMF）或使用训练弹力带。9处骨折（29%）出现需要二次手术干预的并发症。3例为早期感染，需要切开引流、取出内固定物并进行术后颌间固定。1例为骨不连伴错牙合，需要应用更坚固的骨板。5处骨折出现晚期慢性肿胀和低度感染，需要取出钢板。这些病例均已发生骨愈合，无需颌间固定。本研究中采用的使用两枚微型动力加压钢板的方法，被发现是一种治疗下颌角骨折相对简便但效果不可预测的方法。
