Uglesic Vedran, Knezevic Predrag, Kosutic Damir, Jokic Davor
Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
Ann Plast Surg. 2004 Apr;52(4):349-53. doi: 10.1097/01.sap.0000106890.29238.f2.
The authors' experience with 2-lag screw technique for the stabilization of a straight midline mandibulotomy approach for oral cavity and oropharyngeal tumors is presented. Fixation is performed with 2.0-mm pretapped screws. A washer is used to prevent sinking of the screw head into spongy bone and to provide equal pressure distribution of the screw head to the bone edges. Lag screw fixation was used in 24 patients, 18 of whom underwent a full dose of irradiation therapy postoperatively. Two patients developed salivary fistula and 1 developed a local infection. In all patients there were no signs of mandibulotomy site instability, no disturbance of the occlusion, and radiography showed excellent bone healing. There were no indications for tooth extraction to complete the osteotomy. Lag screw fixation proved to be an uneventful and straightforward procedure for the stabilization of a straight midline mandibulotomy approach.
本文介绍了作者使用双拉力螺钉技术稳定口腔和口咽肿瘤的直线型中线下颌骨切开术入路的经验。使用2.0毫米预攻丝螺钉进行固定。使用垫圈以防止螺钉头沉入松质骨，并使螺钉头向骨边缘提供均匀的压力分布。24例患者采用拉力螺钉固定，其中18例术后接受了全剂量放疗。2例患者出现唾液瘘，1例发生局部感染。所有患者均无下颌骨切开部位不稳定的迹象，咬合无紊乱，影像学显示骨愈合良好。没有迹象表明需要拔牙来完成截骨术。拉力螺钉固定被证明是稳定直线型中线下颌骨切开术入路的一种简单且顺利的手术方法。
