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下颌骨双侧单侧骨折患者的治疗。

Treatment of patients with double unilateral fractures of the mandible.

作者信息

Cillo Joseph E, Ellis Edward

机构信息

Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA, USA.

出版信息

J Oral Maxillofac Surg. 2007 Aug;65(8):1461-9. doi: 10.1016/j.joms.2006.08.013.

Abstract

PURPOSE

To analyze the outcomes of treatment for double unilateral mandibular fracture.

MATERIALS AND METHODS

Retrospective chart review of patients who were treated between 1994 and 2004 for 2 mandibular fractures on the same side of the mandible. Data collected involved age, gender, race, cause of fracture, treatment modality, length of follow-up, occlusal relationship at last visit, preoperative and postoperative clinical photographs and radiographs, and incidence and management of complications. Standard descriptive statistics were used.

RESULTS

From a total of 1,287 mandibular fractures for which charts were available, 31 double unilateral mandibular fractures were treated during a 10-year period, for an occurrence rate of 2.4%. Demographic characteristics of these patients were similar to those of patients in other published studies on mandibular fracture. Fractures involved angle + body (18/31, 58%), condyle + body (11/31, 35%), and condyle + angle (2/31, 6%). Various treatments were provided for these fractures, but open reduction and internal fixation were applied to at least 1 of the fractures. Follow-up ranged from 6 weeks to 5 months (average, 9.6 weeks). Eight patients (8/31, 25.8%) developed complications involving visible gonial flaring; 3 of these also had cross-bite.

CONCLUSION

Double unilateral mandibular fracture is a rare event. The difficulty inherent in treating these fractures can be alleviated with the use of proper techniques of open reduction and internal fixation; however, treatment continues to be associated with a high complication rate.

摘要

目的

分析双侧下颌骨单发性骨折的治疗结果。

材料与方法

对1994年至2004年间接受双侧下颌骨单发性骨折治疗的患者进行回顾性病历审查。收集的数据包括年龄、性别、种族、骨折原因、治疗方式、随访时间、末次就诊时的咬合关系、术前和术后的临床照片及X线片,以及并发症的发生率和处理情况。采用标准描述性统计方法。

结果

在可获取病历的总共1287例下颌骨骨折中,10年间有31例双侧下颌骨单发性骨折接受了治疗,发生率为2.4%。这些患者的人口统计学特征与其他已发表的下颌骨骨折研究中的患者相似。骨折部位包括角部+体部(18/31,58%)、髁突+体部(11/31,35%)和髁突+角部(2/31,6%)。针对这些骨折采用了多种治疗方法,但至少有一处骨折采用了切开复位内固定术。随访时间为6周至5个月(平均9.6周)。8例患者(8/31,25.8%)出现并发症,表现为明显的下颌角增宽;其中3例还伴有反合。

结论

双侧下颌骨单发性骨折是一种罕见情况。采用适当的切开复位内固定技术可减轻治疗这些骨折所固有的难度;然而,治疗仍伴有较高的并发症发生率。

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