Akhiwu B I, Efunkoya A A, Omeje K U, Amole I O, Osunde D O, Isa L
Department of Dental and Maxillofacial Surgery,Jos University Teaching Hospital, Jos, Nigeria.
Department of Oral and Maxillofacial Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria.
J West Afr Coll Surg. 2015 Apr-Jun;5(2):66-83.
Fractures of the mandible are the commonest facial fractures and various treatment modalities exist like wire osteosynthesis and the use of miniplates and screw with most of the industrially developed world leaning towards the use of miniplates in the treatment of these fractures. The use has however been limited in developing countries (including Nigeria) mostly due to the cost of the plates and screws.
To identify the versatility of miniplates in the treatment of mandibular fractures at a tertiary care centre in a developing country.
All Subjects aged 16 years and above in whom mandibular fractures were diagnosed were recruited over a two year period. Patients were treated under general anesthesia using either the miniplates and screws or wire osteosynthesis while some patients had both miniplates and maxillo-maxillary fixation.
A total of 94 patients were recruited for the study of which 89.4% were males while the age group 16 to 25 years constituted the majority. Though 29.8% of the study population was involved in business, only 9.6 % were professional motorcyclists. Motorcycle-related road traffic crashes constituted the commonest aetiologic agent with 41.5%, while combination fractures were the commonest fracture types seen in 54.3% of the study participants. Of the 94 patients, 77.7% had treatment of mandibular fractures by open reduction and immobilization with mini plates, while 7.4% had mini plates with Maxillo-maxillary fixation and 14.9% had wire osteosynthesis only. The site of fracture was significantly associated with the treatment modality (p= 0.02).
This study showed that the choice of fixation appliances in mandibular fractures was influenced by the number of fractures and the multiplicity of fracture sites. Miniplates offered functionally stable fixation with minimum complications.
下颌骨骨折是最常见的面部骨折,存在多种治疗方式,如钢丝骨固定术以及使用微型钢板和螺钉,大多数工业发达国家倾向于使用微型钢板治疗这些骨折。然而,在发展中国家(包括尼日利亚),其使用受到限制,主要原因是钢板和螺钉的成本。
确定微型钢板在发展中国家一家三级医疗中心治疗下颌骨骨折中的多功能性。
在两年期间招募所有16岁及以上被诊断为下颌骨骨折的受试者。患者在全身麻醉下接受治疗,使用微型钢板和螺钉或钢丝骨固定术,而一些患者同时使用微型钢板和上颌间固定。
共招募了94名患者进行研究,其中89.4%为男性,16至25岁年龄组占大多数。虽然29.8%的研究人群从事商业活动,但只有9.6%是职业摩托车手。与摩托车相关的道路交通事故是最常见的病因,占41.5%,而复合骨折是最常见的骨折类型,在54.3%的研究参与者中可见。在94名患者中,77.7%通过切开复位并用微型钢板固定治疗下颌骨骨折,7.4%使用微型钢板并进行上颌间固定,14.9%仅采用钢丝骨固定术。骨折部位与治疗方式显著相关(p = 0.02)。
本研究表明,下颌骨骨折固定器械的选择受骨折数量和骨折部位多样性的影响。微型钢板提供功能稳定的固定,并发症最少。