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小型和大型钛板在治疗下颌骨骨折方面同样有效。

Small and large titanium plates are equally effective for treating mandible fractures.

作者信息

Bouloux Gary F, Chen Shuo, Threadgill Jonathan M C

机构信息

Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA.

出版信息

J Oral Maxillofac Surg. 2012 Jul;70(7):1613-21. doi: 10.1016/j.joms.2012.02.029.

Abstract

PURPOSE

The use of small titanium plates for the management of mandibular fractures continues to be a source of controversy because of their load-sharing properties. The purpose of the present study was to determine whether the use of small plates for mandibular fractures is as efficacious as large plates in a large level I trauma center.

MATERIALS AND METHODS

Consecutive subjects presenting with mandibular fractures were randomly allocated to the use of either small plates (group 1) or large plates (group 2). The primary predictor variable was the plate size. The primary outcome variable was fracture union. The secondary outcomes included complications and operative time. Statistical analysis was performed using the Wilcoxon rank sum test for ordinal and continuous variables and the χ(2) test or Fisher exact test for proportions.

RESULTS

A total of 127 consecutive subjects with a fracture of the mandible were enrolled in the study. Of the 127 subjects, 53 completed the required follow-up of at least 6 weeks. There was no difference in the rate of fracture union between the 2 groups (P = .95).

CONCLUSIONS

The study findings suggest that the use of small plates and monocortical screws for mandibular fractures results in favorable outcomes compared with using larger plates and bicortical screws.

摘要

目的

由于小型钛板的负荷分担特性,其在治疗下颌骨骨折中的应用一直存在争议。本研究的目的是在一家大型一级创伤中心确定在下颌骨骨折治疗中使用小型钛板是否与大型钛板一样有效。

材料与方法

连续纳入下颌骨骨折患者,随机分为使用小型钛板组(第1组)和大型钛板组(第2组)。主要预测变量是钛板尺寸。主要结局变量是骨折愈合。次要结局包括并发症和手术时间。对有序和连续变量采用Wilcoxon秩和检验,对比例采用χ²检验或Fisher精确检验进行统计分析。

结果

本研究共纳入127例连续的下颌骨骨折患者。其中53例完成了至少6周的必要随访。两组骨折愈合率无差异(P = 0.95)。

结论

研究结果表明,与使用大型钛板和双皮质螺钉相比,使用小型钛板和单皮质螺钉治疗下颌骨骨折可获得良好效果。

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