Iizuka T, Lindqvist C
Department of Oral and Maxillofacial Surgery, University Central Hospital, Helsinki, Finland.
Int J Oral Maxillofac Surg. 1992 Apr;21(2):65-9. doi: 10.1016/s0901-5027(05)80533-8.
The results are reported on 214 patients treated for 270 mandibular fractures, using rigid internal fixation. Of these, 172 fractures (63.7%) in 131 patients had been re-evaluated at final follow-up in connection with plate and screw removal, on average 15.2 months, postoperatively. Although one-third of the patients had a history of alcohol abuse, and 86% were treated with a delay of more than 24 h (mean 3.2 days), good primary bone healing was observed in 93.9% of the patients. Infections, seen in 6.1% of the patients, were related exclusively to inadequate stability of the fracture. Malocclusion, observed in 18.2% of 159 dentate patients, was caused by incorrect plate bending and insufficient fracture reduction. Immediate postoperative dysfunction of the inferior alveolar nerve in 58.1% of the cases, and of the mandibular branch of the facial nerve in 12.7%, was followed by almost total recovery 1 year after operation. It is concluded that rigid internal fixation is a reliable method of treatment, especially indicated for patients with reduced healing capacity and poor co-operation.
报告了214例接受坚固内固定治疗270处下颌骨骨折患者的结果。其中，131例患者的172处骨折（63.7%）在术后平均15.2个月的最终随访时因取出接骨板和螺钉而再次接受评估。尽管三分之一的患者有酗酒史，86%的患者治疗延迟超过24小时（平均3.2天），但93.9%的患者观察到良好的一期骨愈合。6.1%的患者出现感染，均与骨折稳定性不足有关。159例有牙患者中18.2%出现咬合不正，系接骨板弯曲不当和骨折复位不充分所致。58.1%的病例术后即刻出现下牙槽神经功能障碍，12.7%出现面神经下颌支功能障碍，术后1年几乎完全恢复。结论是，坚固内固定是一种可靠的治疗方法，尤其适用于愈合能力降低和合作性差的患者。
