Ajmal Samira, Khan Muhammad Ayub, Jadoon Huma, Malik Saleem A
Department of Plastic Surgery, Pakistan Institute of Medical Sciences, Islamabad.
J Ayub Med Coll Abbottabad. 2007 Jul-Sep;19(3):51-5.
Maxillofacial trauma is very frequent and associated with a high incidence of mandibular fractures. Although there is universal agreement as to the treatment goals and basic therapeutic principles of reduction and stabilization, a variety of currently accepted treatment modalities indicate a lack of consensus. The authors evaluate the incidence, etiology, management and complications of 344 mandibular fractures in 228 patients treated in the Department of Plastic and Reconstructive Surgery at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan, during a three year period. Indications and techniques for closed and open treatment of mandibular fractures are reviewed along with any complications of these fractures or their management.
A total of 344 mandibular fractures in 228 patients were included in this study. The sex, age, etiology, presentation, fracture characteristics, associated injuries, various methods of management and any pre or postoperative complications were evaluated.
Although various devices and techniques have been used to treat these fractures, modern plate and screw fixation systems have proved to provide the best rigid stabilization, early mobility and associated with least complications. There was a satisfactory bone healing in all the patients and a minimal complication rate associated with open reduction and internal fixation (ORIF).
Mandibular fractures occur with high frequency in road traffic accidents and interpersonal violence. They are among the most common types of facial fractures treated by the plastic surgeons. They must be managed carefully to maintain the function of the mandible, reestablish proper occlusion, and minimize secondary complications. Open reduction and internal fixation has proven to be the most effective method for treatment of mandibular fractures.
颌面创伤十分常见，且下颌骨骨折发生率很高。尽管对于复位和固定的治疗目标及基本治疗原则已达成普遍共识，但目前多种被认可的治疗方式表明仍缺乏统一意见。作者评估了在巴基斯坦伊斯兰堡巴基斯坦医学科学研究所（PIMS）整形与重建外科接受治疗的228例患者中344例下颌骨骨折的发生率、病因、治疗及并发症情况。回顾了下颌骨骨折闭合治疗和开放治疗的适应证及技术，以及这些骨折或其治疗的任何并发症。
本研究纳入了228例患者的344例下颌骨骨折。评估了患者的性别、年龄、病因、临床表现、骨折特征、合并损伤、各种治疗方法以及任何术前或术后并发症。
尽管已使用各种器械和技术来治疗这些骨折，但现代钢板和螺钉固定系统已被证明能提供最佳的坚强固定、早期活动能力，且并发症最少。所有患者均实现了满意的骨愈合，切开复位内固定（ORIF）相关的并发症发生率极低。
下颌骨骨折在道路交通事故和人际暴力中高发。它们是整形外科医生治疗的最常见面部骨折类型之一。必须谨慎处理以维持下颌骨功能、重建正确的咬合关系并尽量减少继发并发症。切开复位内固定已被证明是治疗下颌骨骨折最有效的方法。
