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三种不同可生物降解接骨材料用于颧骨骨折固定的临床应用评估。

An evaluation of the clinical application of three different biodegradable osteosynthesis materials for the fixation of zygomatic fractures.

作者信息

Wittwer Gert, Adeyemo Wasiu Lanre, Voracek Martin, Turhani Dritan, Ewers Rolf, Watzinger Franz, Enislidis Georg

机构信息

Raniomaxillofacial and Oral Surgery Hospital, University of Vienna Medical School, Vienna, Austria.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Dec;100(6):656-60. doi: 10.1016/j.tripleo.2005.03.024.

Abstract

OBJECTIVE

The aim of this prospective study was to compare the clinical handling of 3 different biodegradable osteosynthesis materials and to determine whether they can be used for the fixation of all types of zygomatic fractures.

STUDY DESIGN

A total of 54 consecutive patients who presented with displaced fractures of the zygomatic bone between October 2001 and May 2003 were randomly allocated to 3 biodegradable material groups for the fixation of the fractures. A titanium fixation system was used as rescue osteosynthesis whenever biodegradable materials failed.

RESULTS

Seventy-one (75.5%) of 94 fracture sites were fixed with biodegradable osteosynthesis; 23 (24.5%) had to be fixed with titanium plates and screws. No statistically significant difference was found between the 3 biodegradable materials with regard to their suitability for zygomatic fracture fixation (P = .16). Nonstable fixation (n = 7) or the need to fix small fragments (n = 16) were the reasons for using the titanium fixation system as rescue osteosynthesis at these sites. Biodegradable materials were most frequently unfeasible for use at the infraorbital rim and in the zygomaticomaxillary/anterior sinus wall area.

CONCLUSIONS

It was possible to stabilize 3 of 4 zygomatic fractures with 1.5- or 1.7-mm biodegradable osteosynthesis. Insufficient fracture stabilization, especially at the infraorbital rim and the zygomaticomaxillary crest/anterior sinus wall, was the main reason to switch to titanium osteosynthesis. The biodegradable screw design is possibly too bulky for these particular bony structures.

摘要

目的

本前瞻性研究旨在比较3种不同可生物降解接骨材料的临床应用情况,并确定它们是否可用于固定所有类型的颧骨骨折。

研究设计

2001年10月至2003年5月期间,共有54例连续的颧骨移位骨折患者被随机分配到3个可生物降解材料组进行骨折固定。当可生物降解材料固定失败时,使用钛固定系统作为补救性骨合成。

结果

94个骨折部位中的71个(75.5%)采用可生物降解接骨材料固定;23个(24.5%)不得不使用钛板和螺钉固定。在颧骨骨折固定的适用性方面,3种可生物降解材料之间未发现统计学上的显著差异(P = 0.16)。不稳定固定(n = 7)或需要固定小骨折块(n = 16)是在这些部位使用钛固定系统作为补救性骨合成的原因。可生物降解材料最常在眶下缘以及颧骨上颌/前窦壁区域使用不可行。

结论

使用1.5或1.7毫米可生物降解接骨材料能够稳定四分之三的颧骨骨折。骨折固定不足,尤其是在眶下缘和颧骨上颌嵴/前窦壁处,是改用钛骨合成的主要原因。对于这些特定的骨结构,可生物降解螺钉的设计可能过于笨重。

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