Hashemi Hamid Mahmood, Parhiz Alireza
Department of Oral and Maxillofacial Surgery, Shariati Hospital, Tehran, Iran.
J Oral Maxillofac Surg. 2011 May;69(5):1411-4. doi: 10.1016/j.joms.2010.05.070. Epub 2011 Jan 8.
The most important part of facial bone fracture treatment is immobilization. Bandaging of the fractured mandible was the first immobilization device used in ancient Greece. Since then, various methods with different shapes and uses were introduced in the treatment of maxillofacial trauma patients. Intermaxillary fixation (IMF) with bone screws was first used in 1981. This technique has advantages, including quickness, ease of use, less trauma, and reduced risk of needle-stick injury. We analyze the advantages and disadvantages of this technique.
In a retrospective study on 73 patients requiring IMF, the complications of IMF screws were analyzed. Complications were divided into 2 groups: dental and nondental. Follow-up examinations consisted of clinical and panoramic radiographic examinations.
In 24 teeth (6.5%) in 13 patients (17.8%), dental complications occurred. No dental treatment was needed in 4 patients (5.5%). The site at which dental complications occurred during operation in the majority of cases was the anterior mandible. Nondental complications occurred in 63 screws (16.9%) in 39 patients (54.2%). The most common complication was screw loosening. Screw soft tissue coverage occurred in 21 screws.
The use of IMF screws is simple and decreases the time required for surgery, but because of their complications, they still require punctuality.
面部骨折治疗中最重要的部分是固定。下颌骨骨折的绷带包扎是古希腊首次使用的固定装置。从那时起,在颌面创伤患者的治疗中引入了各种形状和用途不同的方法。1981年首次使用带骨螺钉的颌间固定(IMF)。这项技术具有诸多优点,包括操作迅速、使用简便、创伤较小以及针刺伤风险降低。我们分析了这项技术的优缺点。
在一项对73例需要进行颌间固定的患者的回顾性研究中,分析了颌间固定螺钉的并发症。并发症分为两组:牙齿相关和非牙齿相关。随访检查包括临床检查和全景X线检查。
13例患者(17.8%)的24颗牙齿(6.5%)出现了牙齿相关并发症。4例患者(5.5%)无需进行牙科治疗。大多数病例中手术期间发生牙齿相关并发症的部位是下颌前部。39例患者(54.2%)的63颗螺钉(16.9%)出现了非牙齿相关并发症。最常见的并发症是螺钉松动。21颗螺钉出现了螺钉软组织覆盖情况。
使用颌间固定螺钉操作简单,减少了手术所需时间,但由于其并发症,仍需要严格遵守操作规范。