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在下颌骨角部骨折的处理中,单一的下颌骨下缘迷你板是否足够?

Is a single miniplate at the inferior border adequate in the management of an angle fracture of the mandible?

机构信息

Department of Oral and Maxillofacial Surgery, Government Dental College, Pt. B.D. Sharma University of Health Sciences, Haryana, India.

出版信息

Otolaryngol Head Neck Surg. 2011 Aug;145(2):213-6. doi: 10.1177/0194599811405408. Epub 2011 Apr 26.

Abstract

OBJECTIVE

This prospective study evaluates the efficacy of using a single miniplate at the inferior border in the management of a displaced angle fracture.

STUDY DESIGN

Case series with chart review.

SETTING

Pt. B.D. Sharma University of Health Sciences.

SUBJECTS AND METHODS

Fifty-two patients with angle fracture of the mandible were evaluated. All fractures were displaced. The displacement of fracture was assessed on panoramic radiography by measuring the displacement of the inferior alveolar canal. Fractures with displacement greater than 2 mm were included in the study. Fixation with a 4-hole noncompression miniplate along the inferior border and 2 bicortical screws on each side of the fracture was done.

RESULTS

Among these 52 patients, 20 sustained isolated angle fracture, 2 sustained bilateral angle fracture, and 30 sustained angle fracture associated with contralateral parasymphysis or body fracture. Five patients (9.5%) experienced complications. All were considered minor and did not require hospitalization. Two had a slight occlusal discrepancy requiring selective occlusal grinding, and 2 minor infections were managed by incision and drainage. One patient suffered from paresis of the facial nerve that resolved itself after 3 months.

CONCLUSION

Based on this single study, at a single institution, we can conclude that outcomes are acceptable in our patients, but there is very limited ability to generalize the results to different practice settings. Because of these limitations, a multicenter study with an appropriate comparison group is required to substantiate a more generalizable conclusion of efficacy of this single miniplate at inferior border.

摘要

目的

本前瞻性研究评估在下颌缘使用单迷你板治疗移位角骨折的疗效。

研究设计

病例系列,病历回顾。

地点

Pt. B.D. Sharma 健康科学大学。

受试者和方法

评估了 52 例下颌角骨折患者。所有骨折均有移位。通过测量下牙槽神经管的移位来评估全景片上骨折的移位。将移位大于 2mm 的骨折纳入研究。用沿下颌缘的 4 孔非压缩迷你板和骨折两侧的 2 皮质螺钉固定。

结果

在这 52 例患者中,20 例为单纯角骨折,2 例为双侧角骨折,30 例为角骨折合并对侧升支或体部骨折。5 例(9.5%)发生并发症。均为轻微并发症,无需住院治疗。2 例有轻微的咬合错位,需要选择性咬合磨平,2 例轻微感染通过切开引流治疗。1 例患者出现面神经瘫痪,3 个月后自行恢复。

结论

根据这一项单中心研究,我们可以得出结论,在我们的患者中,结果是可以接受的,但将结果推广到不同的实践环境的能力非常有限。由于这些限制,需要进行一项多中心研究,并设立适当的对照组,以证实这种在下颌缘使用单迷你板的治疗方法的疗效具有更广泛的适用性。

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