Seemann Rudolf, Perisanidis Christos, Schicho Kurt, Wutzl Arno, Poeschl Wolfgang P, Köhnke Robert, Kinast Bernd, Brunner Johannes, Krennmair Gerald, Ewers Rolf, Klug Clemens
University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jun;109(6):815-9. doi: 10.1016/j.tripleo.2009.11.033. Epub 2010 Mar 17.
Surgical treatment of mandibular neck fractures is frequently associated with postoperative complications. This study aims at an in-depth analysis of complication rates of surgically treated mandibular neck fractures.
All treated patients (264 male, 103 female patients, with 429 mandibular neck fractures) of the Vienna University Clinic of Maxillofacial Surgery in the period of 1995 to 2005 with at least 1 mandibular neck fracture were included.
Of surgically treated fractures, 94.8% healed successfully after 1 open reduction, 4.4% had 2, and 0.8% had 3 open reductions. Osteosynthesis failure was 11.3% for 1 miniplate, 6.7% for 2 miniplates, and 8.5% for 1 lag screw. Of the surgically treated, 53 (21.3%) had 1 complication, 12 (4.8%) had 2, and 4 (1.6%) had 3 complications. Comparing isolated and mandibular neck fractures combined with other mandibular fractures the risk of suffering osteosynthesis failure is 3.59 in case of isolated (P = .004).
Predominant causes of revision surgery are osteosynthesis failure, pseudarthrosis, and malposition.
下颌骨颈部骨折的手术治疗常伴有术后并发症。本研究旨在深入分析手术治疗下颌骨颈部骨折的并发症发生率。
纳入1995年至2005年期间维也纳大学颌面外科诊所所有接受治疗的患者（男性264例，女性103例，共429例下颌骨颈部骨折），这些患者至少有1例下颌骨颈部骨折。
在接受手术治疗的骨折中，94.8%在1次切开复位后成功愈合，4.4%进行了2次，0.8%进行了3次切开复位。单块微型钢板的骨合成失败率为11.3%，两块微型钢板为6.7%，一枚拉力螺钉为8.5%。在接受手术治疗的患者中，53例（21.3%）发生1种并发症，12例（4.8%）发生2种，4例（1.6%）发生3种并发症。将单纯下颌骨颈部骨折与合并其他下颌骨骨折的情况进行比较，单纯骨折发生骨合成失败的风险为3.59（P = .004）。
翻修手术的主要原因是骨合成失败、假关节形成和错位。
