Stuck B A, Heller T
Universitäts-HNO-Klinik, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer-1-3, 68167, Mannheim, Deutschland.
HNO. 2011 Nov;59(11):1088-92. doi: 10.1007/s00106-011-2386-9.
The material used for osteosynthesis plays a crucial role in the management of facial fractures. Plates need to be flexible enough to be bent and should not be palpable through the skin, while ensuring stable fixation und adequate biocompatibility. Although stainless steel was initially the material of choice, titanium has become the standard material due to its superior biocompatibility. While the explantation of titanium plates and screws appears unnecessary in general, it should be considered in cases of dislocation, cosmetic concerns, pain and infection. Due to their limited initial stability and a potential increase in local complications, resorbable materials based on polymeric lactose are used with caution in midfacial fractures in adults. Our own retrospective study comparing the postoperative complications after fixation of lateral midfacial fractures with titanium and resorbable systems demonstrated a low complication rate for both systems (7-8%) and no statistically significant difference between the two. The appropriate material for fixation should be selected based on the localization and severity of the fracture, the experience of the surgeon as well as on the age and overall condition of the patient.
用于骨固定的材料在面部骨折的治疗中起着至关重要的作用。钢板需要足够柔韧以便弯曲，且不应透过皮肤被摸到，同时要确保稳定固定和足够的生物相容性。尽管不锈钢最初是首选材料，但由于钛具有卓越的生物相容性，它已成为标准材料。虽然一般情况下取出钛板和螺钉似乎没有必要，但在出现移位、美观问题、疼痛和感染的情况下应予以考虑。由于基于聚乳糖的可吸收材料初始稳定性有限且局部并发症可能增加，在成人面中部骨折中应谨慎使用。我们自己的一项回顾性研究比较了使用钛和可吸收系统固定面中侧部骨折后的术后并发症，结果显示两种系统的并发症发生率都很低（7 - 8%），且两者之间无统计学显著差异。应根据骨折的部位和严重程度、外科医生的经验以及患者的年龄和整体状况来选择合适的固定材料。
