Thaller S R, Reavie D, Daniller A
Department of Surgery, University of California, School of Medicine, Davis 95817.
Ann Plast Surg. 1990 Jun;24(6):469-74. doi: 10.1097/00000637-199006000-00001.
Traditional methods of fixation for stabilization of mandible fractures primarily center around intermaxillary fixation with or without open reduction. During the past decade, rigid internal fixation with miniplates and screws has attained widespread acceptance in the management of acute traumatic injuries to the mandible. With continuing emphasis on cost containment in health care delivery, plastic surgeons will be expected to justify their therapeutic methods as beneficial as well as cost-effective. This is particularly important when a number of acceptable procedures are readily available. The purpose of our investigation was retrospectively to compare treatment with intermaxillary fixation alone, interosseous wire osteosynthesis, and rigid internal fixation with miniplates and screws. We analyzed the hospital records of three such treatment groups, each consisting of 25 patients. Despite initial purchase costs, increased operating time, and the need to develop the skills required to apply the hardware, our study clearly demonstrated that miniplates and screws remain a cost-effective approach to caring for fractures of the mandible. Associated advantages include a quicker return to a preinjury life-style, decreased weight loss, improved oral hygiene and wound care, and protection of the airway, thereby eliminating monitored intensive care unit admissions.
传统的下颌骨骨折固定方法主要围绕颌间固定展开，有或没有切开复位。在过去十年中，微型钢板和螺钉的坚固内固定在急性下颌骨创伤性损伤的治疗中已得到广泛认可。随着医疗保健服务中对成本控制的持续重视，整形外科医生需要证明其治疗方法既有益又具有成本效益。当有多种可接受的手术方法时，这一点尤为重要。我们研究的目的是回顾性比较单纯颌间固定、骨间钢丝骨缝合术和微型钢板及螺钉坚固内固定的治疗效果。我们分析了三个这样的治疗组的医院记录，每组由25名患者组成。尽管有初始购置成本、手术时间增加以及需要培养应用硬件所需的技能，但我们的研究清楚地表明，微型钢板和螺钉仍然是治疗下颌骨骨折的一种具有成本效益的方法。相关优势包括更快恢复到伤前生活方式、体重减轻减少、口腔卫生和伤口护理改善以及气道保护，从而避免了进入监护重症监护病房。
