Özkan Heval Selman, Irkoren Saime, Durum Yasemin, Karaca Can
Department of Plastic and Reconstructive Surgery, Adnan Menderes University, Aydin, Turkey.
Department of Radiology, Adnan Menderes University, Aydin, Turkey.
Facial Plast Surg. 2016 Feb;32(1):105-10. doi: 10.1055/s-0036-1571350. Epub 2016 Feb 10.
When fractured, mandible angulates. For better preoperative evaluation, movements of fractured mandibular segments should be documented in x-, y-, and z-axes. This article quantitatively evaluates the pattern and degree of the angulation. Fifty-two patients with mandible fractures were involved in this study. After defining a three-dimensional (3D) coordination system consisting of the x-axis (the axis directed from the medial to lateral side of the skull), y-axis (directed from the inferior to superior side), and z-axis (directed from the posterior to anterior side), the degree with which the fractured mandible angulated around each of these axes was measured using 3D graphic software. The tendency of the angulation was compared between the three axes. Frequency of complications, operation times, maxilla mandibular fixation (MMF) need, and epidemiologic data were compared with the angulation results. Angulation around the x-axis was the most frequent with a 55.8% incidence, followed by a substantial margin of angulation around the y-axis with a 21.2% incidence; angulation around the z-axis was rare, with an incidence of 15.4%. Furthermore, the degree of z-axis angulation was minor compared with x- and y-axes angulations. There were statistically increased rate of complications, operation time, and MMF need in patients with more than 10 degrees of angulation in any case. Operation time and complication rates are also increased in patients with internal rotation of the proximal segment. Preoperative evaluation of mandible fracture angulation degree is useful for determining postoperative complication rates, MMF need, and operative challenge. This finding is helpful for effective performance to reposition the fractured mandible.
下颌骨骨折时会发生成角。为了进行更好的术前评估，应记录骨折下颌骨段在x、y和z轴上的运动情况。本文对成角的模式和程度进行了定量评估。本研究纳入了52例下颌骨骨折患者。在定义了一个由x轴（从颅骨内侧指向外侧的轴）、y轴（从下向上指向的轴）和z轴（从后向前指向的轴）组成的三维（3D）坐标系后，使用3D图形软件测量骨折下颌骨围绕这些轴各自成角的程度。比较了三个轴之间的成角趋势。将并发症发生率、手术时间、颌间固定（MMF）需求以及流行病学数据与成角结果进行了比较。围绕x轴的成角最为常见，发生率为55.8%，其次是围绕y轴的成角，发生率为21.2%，有相当大的差距；围绕z轴的成角很少见，发生率为15.4%。此外，与x轴和y轴的成角相比，z轴成角的程度较小。在任何情况下，成角超过10度的患者并发症发生率、手术时间和MMF需求在统计学上均增加。近端骨折段内旋的患者手术时间和并发症发生率也会增加。术前评估下颌骨骨折的成角程度有助于确定术后并发症发生率、MMF需求和手术难度。这一发现有助于有效地对骨折下颌骨进行复位。
