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[下颌骨重建术后与钢板相关的并发症]

[Plate related complication after mandibular reconstruction].

作者信息

Liu Shang-ping, Cai Zhi-gang, Zhang Jie, Zhang Jian-guo, Zhang Yi

机构信息

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China. Email:

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2013 Oct;48(10):586-90.

Abstract

OBJECTIVE

To evaluate the complications and factors associated with titanium plates in mandibular reconstruction with different methods.

METHODS

A retrospective analysis of 660 patients who received primary reconstruction of the mandible was conducted. The characters of the mandibular defect and methods of reconstruction were recorded. The complications and factors associated with the reconstruction were analyzed.

RESULTS

The majority of mandibular defect was in a shape of L (n = 324 ). The total complication rate was 14.7% (97/660), which included screw loosening 5.8% (38/660), plate fracture 3.3% (22/660), plate exposure 3.8% (25/660), infection 7.4% (49/660) and malunion or ununion 2.9% (19/660). The mandibular defects reconstructed by reconstructive plates had a higher complication rate than that by bone grafts. The complication rate was 10.8% (63/586) in cases reconstructed by bone grafts with miniplates. The complications were associated with radiation therapy and diabetes. Radiation therapy had a significant effect on plate exposure.

CONCLUSIONS

Reconstruction with bone grafts can minimize the rate of plate related complication. The complications were associated with radiation therapy and diabetes.

摘要

目的

评估不同方法下颌骨重建中钛板相关的并发症及相关因素。

方法

对660例行下颌骨一期重建的患者进行回顾性分析。记录下颌骨缺损特点及重建方法。分析重建相关的并发症及因素。

结果

下颌骨缺损多数呈L形(n = 324)。总并发症发生率为14.7%(97/660),其中螺钉松动5.8%(38/660),钢板断裂3.3%(22/660),钢板外露3.8%(25/660),感染7.4%(49/660),骨不连或骨愈合不良2.9%(19/660)。采用重建钢板重建的下颌骨缺损并发症发生率高于采用骨移植者。采用微型钢板辅助骨移植重建的病例并发症发生率为10.8%(63/586)。并发症与放射治疗和糖尿病有关。放射治疗对钢板外露有显著影响。

结论

骨移植重建可使钢板相关并发症发生率降至最低。并发症与放射治疗和糖尿病有关。

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