Alpert Brian, Kushner George M, Tiwana Paul S
Department of Surgical and Hospital Dentistry, University of Louisville School of Dentistry, University of Louisville Affiliated Hospitals, Louisville, Kentucky.
Craniomaxillofac Trauma Reconstr. 2008 Nov;1(1):25-9. doi: 10.1055/s-0028-1098959.
The treatment of infected mandibular fractures has advanced rather dramatically over the past 50 years. Immobilization with maxillomandibular fixation and/or splints, removal of diseased teeth in the fracture line, external fixation, use of antibiotics, debridement, and rigid internal fixation has played a role in management. Perhaps the most important advance was the realization that infected fractures also result from moving fragments and nonvital bone, not just bacteria. Controlling movement and eliminating the dead bone allowed body defenses to also eliminate bacteria. The next logical step in the evolution of treatment was primary bone grafting of the resulting defect following application of rigid internal fixation and debridement of the dead bone. We offer our results with this treatment in 21 infected fractures, 20 of which achieved primary union.
在过去50年里，感染性下颌骨骨折的治疗取得了相当显著的进展。采用颌间固定和/或夹板固定、拔除骨折线上的患牙、外固定、使用抗生素、清创以及坚强内固定等方法在治疗中发挥了作用。或许最重要的进展是认识到感染性骨折不仅是由细菌引起的，活动的骨折碎片和无活力的骨组织也会导致感染。控制骨折部位的活动并清除死骨，使机体防御机制能够清除细菌。治疗方法演变的下一个合理步骤是在应用坚强内固定并清除死骨后，对 resulting defect 进行一期骨移植。我们报告了采用这种治疗方法治疗21例感染性骨折的结果，其中20例实现了一期愈合。
原文中“resulting defect”表述不太准确，可能是有遗漏信息，这里暂且按字面翻译。
