Bui Peter, Demian Nagi, Beetar Patrick
Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center-Houston, Houston, TX 77030, USA.
J Oral Maxillofac Surg. 2009 Apr;67(4):804-8. doi: 10.1016/j.joms.2008.08.034.
The aim of this study was to determine the rate of postoperative infection and the efficacy of removing teeth in the line of mandibular angle fractures treated with 2.0-mm 8-hole titanium curved strut plates. Our understanding is that this method of repair is currently being used only in a few centers in the United States.
A retrospective review of mandibular angle fractures treated with a 2.0-mm 8-hole strut plate during a 4-year period. Postoperative antibiotics were given for 1 week. Follow-up appointments were 4 weeks or longer. A nonchewing diet was instructed for 6 weeks. Data for all selected patients include the information such as age, gender, etiology of injuries, medical history, concurrent injuries, nerve deficits, pre- and postoperative antibiotic administration, postop infection, a presence or absence of teeth in the line of fractures, and whether these teeth were removed.
Four patients (4 of 49 or 8.2%) developed infections. Two of those patients had a tooth in the line of a fracture that was retained (2 of 14 or 14%). The third had a tooth in the line of a fracture that was extracted (1 of 18 or 5.6%). The fourth patient was 1 of the 17 patients who did not have teeth in the line of fracture and developed infection (1 of 17 or 5.9%). None of the patients developed failed hardware, malunion, nonunion, malocclusion, or iatrogenic nerve injury.
The use of a 2.0-mm 8-hole strut plate is associated with a low infection rate (8.2%). The infection rate for those mandibular angle fractures with teeth in the line of fracture retained was 14% compared with 5.6% for those fractures with the teeth in the line of fracture extracted.
本研究的目的是确定采用2.0毫米8孔钛制弯形支撑钢板治疗下颌角骨折时术后感染率以及拔牙的疗效。据我们了解,这种修复方法目前仅在美国少数几个中心使用。
对4年间采用2.0毫米支撑钢板治疗的下颌角骨折进行回顾性研究。术后给予抗生素治疗1周。随访时间为4周或更长。指导患者6周内采用非咀嚼饮食。所有选定患者的数据包括年龄、性别、损伤病因、病史、并发损伤、神经功能缺损、术前和术后抗生素使用情况、术后感染、骨折线上是否有牙齿以及这些牙齿是否被拔除等信息。
4例患者(49例中的4例,占8.2%)发生感染。其中2例患者骨折线上的牙齿被保留(14例中的2例,占14%)。第3例患者骨折线上的牙齿被拔除(18例中的1例,占5.6%)。第4例患者是17例骨折线上无牙齿且发生感染的患者之一(17例中的1例,占5.9%)。所有患者均未出现内固定失败、畸形愈合、骨不连、咬合不正或医源性神经损伤。
使用2.0毫米8孔支撑钢板的感染率较低(8.2%)。骨折线上牙齿被保留的下颌角骨折感染率为14%,而骨折线上牙齿被拔除的骨折感染率为5.6%。