Khiabani Kazem S, Mehmandoost Meghdad Khanian
Oral and Maxillofacial Surgery, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran.
Craniomaxillofac Trauma Reconstr. 2013 Jun;6(2):107-14. doi: 10.1055/s-0033-1333878. Epub 2013 Mar 13.
Background and Objectives The ideal line of osteosynthesis in mandibular angle fractures indicates that a plate might be placed either along or just below the external oblique ridge. Some authors believe that using one miniplate at this line at the mandibular angle region provides sufficient strength to stabilize the fracture but others imply a second plate is required. Such controversies exist in the use of maxillomandibular fixation (MMF). The intention of the present study was to compare efficiency and complications of using one miniplate with and without MMF in mandibular angle fractures. Methods and Materials Forty patients with facial trauma with mandibular angle fractures including displaced and unfavorable fractures were categorized into two groups of 20 persons. In all patients, one miniplate was placed on the external oblique ridge. In the first group, patients had light maxillomandibular elastic bands just after surgery but no rigid MMF. In the second group, patients had rigid MMF for 2 weeks after surgery. Patients were followed to evaluate complications and treatment efficiency. Conclusions Our study showed that use of a single miniplate in the external oblique ridge is a functionally stable treatment for all types of angle fractures (including displaced and unfavorable fractures) except comminuted and long oblique fractures, which were not included in our study. Use of postoperative MMF did not improve the results.
背景与目的 下颌角骨折的理想接骨线表明,接骨板可置于外斜线处或其稍下方。一些作者认为,在下颌角区域此接骨线处使用一块微型接骨板就足以稳定骨折,但另一些人则认为需要第二块接骨板。在颌间固定(MMF)的使用方面也存在此类争议。本研究旨在比较在下颌角骨折中使用一块微型接骨板并辅以或不辅以MMF的疗效及并发症。
方法与材料 将40例伴有下颌角骨折(包括移位骨折和不良骨折)的面部创伤患者分为两组,每组20人。所有患者均在外斜线上放置一块微型接骨板。第一组患者术后仅使用轻质颌间弹性绷带,不进行坚固的MMF。第二组患者术后进行2周的坚固MMF。对患者进行随访以评估并发症和治疗效果。
结论 我们的研究表明,在外斜线上使用单一微型接骨板对除粉碎性骨折和长斜形骨折(本研究未纳入)之外的所有类型的角部骨折(包括移位骨折和不良骨折)都是一种功能稳定的治疗方法。术后使用MMF并未改善治疗结果。