Kotrashetti S M, Singh A G
Department of Oral and Maxillofacial Surgery, V.K. Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India.
Department of Oral and Maxillofacial Surgery, V.K. Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India.
Int J Oral Maxillofac Surg. 2017 Jan;46(1):54-58. doi: 10.1016/j.ijom.2016.08.006. Epub 2016 Aug 29.
The principle of axial compression for better adaptation of fracture segments, with the advantage of increased stability and early function, is a promising means of avoiding the bulky rigid plates used previously. This study was done to compare the treatment outcomes between Herbert screw and lag screw fixation in mandibular fractures. Thirty patients with oblique displaced or undisplaced mandibular fractures requiring open reduction and internal fixation with rigid screw fixation, under general anaesthesia, were included. Herbert screws were used in 15 patients (group 1) and lag screws were used in the other 15 patients (group 2). Patients were followed up at 1 week, 6 weeks, 3 months, and 6 months for postoperative occlusion, inter-fragmentary mobility, pain, nerve sensation, and isodensity values on panoramic radiographs. Postoperative occlusion, inter-fragmentary mobility, pain, and nerve sensation were similar in the two groups. Group 1 patients attained isodensity values similar to the final follow-up value much faster than group 2 patients (P<0.05). This study strongly suggests that the use of Herbert screws results in significantly faster healing as compared to lag screws, in terms of achieving higher isodensity values faster.
轴向加压原理有助于骨折段更好地适应，具有增加稳定性和早期功能的优势，是一种有望避免以往使用的笨重刚性钢板的方法。本研究旨在比较Herbert螺钉和拉力螺钉固定下颌骨骨折的治疗效果。纳入30例需要在全身麻醉下进行切开复位并用刚性螺钉内固定的斜行移位或无移位下颌骨骨折患者。15例患者使用Herbert螺钉（第1组），另外15例患者使用拉力螺钉（第2组）。在术后1周、6周、3个月和6个月对患者进行随访，观察术后咬合、骨折段间活动度、疼痛、神经感觉以及全景X线片上的等密度值。两组患者的术后咬合、骨折段间活动度、疼痛和神经感觉相似。第1组患者达到与最终随访值相似的等密度值的速度比第2组患者快得多（P<0.05）。这项研究强烈表明，就更快达到更高等密度值而言，使用Herbert螺钉比拉力螺钉能使骨折愈合明显更快。
