Wittwer Gert, Adeyemo Wasiu Lanre, Yerit Kaan, Voracek Martin, Turhani Dritan, Watzinger Franz, Enislidis Georg
Oral and Maxillofacial Surgery, University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Austria.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Apr;101(4):419-25. doi: 10.1016/j.tripleo.2005.07.026. Epub 2006 Jan 19.
Biodegradable materials are particularly useful for the fixation of zygomatic fractures. Different systems are commercially available. The aim of this study was to compare the clinical outcome of zygomatic fracture fixation using 3 biodegradable systems and a titanium osteosynthesis system.
Patients with displaced fractures of the zygomatic bone presenting at our department from October 2001 to May 2003 were randomly allocated to 1 of 3 treatment groups for fracture fixation (study group A: LactoSorb: n = 18; study group B: BioSorb: n = 18; study group C: Delta: n = 18). Treatment outcome and complication rates were compared with a historic patient group with zygomatic fractures fixed with titanium osteosynthesis (control group D: n = 15).
A total of 64 patients (study groups A + B + C: n = 49; control group D: n = 15) were followed for at least 24 months (range: 24 to 44 months). Forty-nine patients in the biodegradable study groups (group A: n = 15; group B: n = 17; group C: n = 17) who had their fractures fixed with biodegradable plates and screws alone or in combination with titanium plates and screws were reviewed postoperatively. Uneventful healing occurred during the entire follow-up period in 39 (80%) out of 49 patients in the biodegradable groups (A + B + C) and in 12 (80%) out of 15 patients in group D. Ten patients in groups A + B + C developed postoperative complications (infection: n = 3; soft tissue dehiscence: n = 2; implant-related tissue reactions: n = 5), compared with 3 patients in group D (soft tissue dehiscence: n = 1; unspecific pain: n = 2) (P = .97). Complications occurred in 4 patients in group A and 3 patients each in groups B and C. Smokers developed significantly more postoperative complications than nonsmokers in groups A + B + C (P = .01).
There was no significant difference between biodegradable osteosynthesis materials or between biodegradable materials and titanium fixation with respect to fracture healing and postoperative complications. Postoperative complications were of a minor nature and resolved spontaneously or after local therapy. Smoking habits may play a significant role in the incidence of complications with biodegradable materials.
可生物降解材料在颧骨骨折固定中特别有用。市场上有不同的系统可供选择。本研究的目的是比较使用3种可生物降解系统和1种钛骨固定系统进行颧骨骨折固定的临床效果。
2001年10月至2003年5月在我科就诊的颧骨移位骨折患者被随机分配到3个骨折固定治疗组中的1组（研究组A：LactoSorb：n = 18；研究组B：BioSorb：n = 18；研究组C：Delta：n = 18）。将治疗结果和并发症发生率与一组采用钛骨固定术治疗颧骨骨折的历史患者组（对照组D：n = 15）进行比较。
共有64例患者（研究组A+B+C：n = 49；对照组D：n = 15）接受了至少24个月（范围：24至44个月）的随访。对49例在可生物降解研究组（A组：n = 15；B组：n = 17；C组：n = 17）中单独使用或联合钛板和螺钉使用可生物降解板和螺钉固定骨折的患者进行了术后复查。在可生物降解组（A+B+C）的49例患者中，有39例（80%）在整个随访期间愈合顺利，在D组的15例患者中有12例（80%）愈合顺利。A+B+C组有10例患者出现术后并发症（感染：n = 3；软组织裂开：n = 2；植入物相关组织反应：n = 5），而D组有3例患者出现并发症（软组织裂开：n = 1；非特异性疼痛：n = 2）（P = 0.97）。A组有4例患者出现并发症，B组和C组各有3例患者出现并发症。在A+B+C组中，吸烟者术后并发症明显多于非吸烟者（P = 0.01）。
在骨折愈合和术后并发症方面，可生物降解骨固定材料之间或可生物降解材料与钛固定之间没有显著差异。术后并发症性质较轻，可自发缓解或经局部治疗后缓解。吸烟习惯可能在可生物降解材料并发症的发生率中起重要作用。
