Feledy Jules, Caterson Edward J, Steger Shon, Stal Samuel, Hollier Larry
Division of Plastic and Reconstructive Surgery, Baylor College of MedicineHouston, Texas, USA.
Plast Reconstr Surg. 2004 Dec;114(7):1711-6; discussion 1717-8. doi: 10.1097/01.prs.0000142477.77232.f7.
Mandibular angle fractures are technically challenging, and a spectrum of techniques for treatment of these fractures has been proposed in the literature. Currently, fixation with one or two miniplates has become a widely accepted method of providing internal fixation and eliminating the need for postoperative maxillomandibular fixation. In this study, the utility of a single 2.0-mm matrix miniplate for mandibular angle fracture management was examined. In a laboratory biomechanical analysis, the overall stability of the single 2.0-mm matrix miniplate compared favorably with two 2.0-mm miniplates in a simulated fracture setting. The matrix miniplate demonstrated an overall better intrinsic stability, more resistance to out-of-plane fracture movement, and a higher load tolerance when motion out-of-plane was challenged. Clinically, the matrix miniplate performed well. In a series of 22 consecutive patients, there were no cases of nonunion, malunion, or plate failure. Two patients developed infection that was managed in both cases by drainage with maintenance of the miniplate. Both went on to full union. These results compare very favorably to previously published series using one or two miniplates.
下颌角骨折在技术上具有挑战性,文献中已经提出了一系列治疗这些骨折的技术。目前,使用一块或两块微型钢板进行固定已成为一种广泛接受的提供内固定并消除术后颌间固定需求的方法。在本研究中,研究了单个2.0毫米基质微型钢板在下颌角骨折治疗中的效用。在实验室生物力学分析中,在模拟骨折环境下,单个2.0毫米基质微型钢板的整体稳定性与两块2.0毫米微型钢板相比具有优势。基质微型钢板表现出整体更好的固有稳定性、更强的抗平面外骨折移动能力以及在平面外运动受到挑战时更高的载荷耐受性。临床上,基质微型钢板表现良好。在连续22例患者的系列研究中,没有出现骨不连、骨畸形愈合或钢板失效的病例。两名患者发生感染,两例均通过引流并保留微型钢板进行处理。两人均实现了完全愈合。这些结果与之前发表的使用一块或两块微型钢板的系列研究相比非常有利。