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采用坚固内固定治疗无牙下颌骨骨折:病例系列及文献综述

Treatment of edentulous mandibular fractures with rigid internal fixation: case series and literature review.

作者信息

Franciosi Edgardo, Mazzaro Eduardo, Larranaga Juan, Rios Alfredo, Picco Pedro, Figari Marcelo

机构信息

Division of Head and Neck, Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina.

出版信息

Craniomaxillofac Trauma Reconstr. 2014 Mar;7(1):35-42. doi: 10.1055/s-0033-1364195. Epub 2014 Jan 14.

Abstract

The aim of the study is to analyze the effectiveness of rigid internal fixation (RIF) for treating edentulous mandibular fractures. Because of the low incidence of fractures in edentulous mandible, there is no consensus of the optimal treatment for it. This study included all edentulous patients with mandibular fracture diagnosis, who were treated with internal fixation at the Hospital Italiano de Buenos Aires from November 1991 to July 2011. Data such as age, gender, etiology and location of fracture, surgical approach, type of osteosynthesis used, and postoperative complications were analyzed. A total of 18 patients, 76.2 years mean age, 12 females (66.6%), presented a total of 35 mandibular fractures. The mandibular body was the most common localization of the fractures. Twenty-five fractures received surgical treatment with RIF, mainly approached extraorally. Reconstruction plates were the most common type of fixation used. Fracture reduction was considered satisfactory in 96.5%, with 22.2% of complications and 11.1% of reoperations needed. Open reduction and RIF demonstrated to be a reliable method for treating edentulous mandibular fractures. Nevertheless, there is lack of high-level recommendation publication to support this.

摘要

本研究的目的是分析坚固内固定(RIF)治疗无牙下颌骨骨折的有效性。由于无牙下颌骨骨折的发生率较低,对于其最佳治疗方法尚无共识。本研究纳入了1991年11月至2011年7月在布宜诺斯艾利斯意大利医院接受内固定治疗的所有诊断为下颌骨骨折的无牙患者。分析了年龄、性别、骨折病因和部位、手术入路、所用骨合成类型及术后并发症等数据。共有18例患者,平均年龄76.2岁,其中12例女性(66.6%),共发生35例下颌骨骨折。下颌体是骨折最常见的部位。25例骨折接受了RIF手术治疗,主要采用口外入路。重建钢板是最常用的固定类型。96.5%的骨折复位情况令人满意,并发症发生率为22.2%,需要再次手术的比例为11.1%。切开复位内固定术被证明是治疗无牙下颌骨骨折的可靠方法。然而,缺乏高水平的推荐性文献支持这一点。

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