Camino Junior Rubens, Moraes Rogério Bonfante, Landes Constantin, Luz João Gualberto C
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, São Paulo, SP, 02036-021, Brazil.
Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil.
Oral Maxillofac Surg. 2017 Sep;21(3):327-334. doi: 10.1007/s10006-017-0636-z. Epub 2017 Jun 12.
A comparative study of the use of the 2.0-mm locking fixation system with conventional systems in the treatment of mandibular fractures was performed.
For this study, 87 consecutive patients with 112 mandibular fractures were randomized to receive either 2.0-mm locking plates (n = 45) or conventional 2.0- or 2.4-mm plates (n = 42) and had a minimum follow-up of 6 months. Fractures were classified based on the degree of displacement and complexity. Statistical analyses were used to verify possible differences between the groups when separately compared unfavourable and favourable cases (p ≤ 0.050).
Despite randomization, systemic diseases were more frequent in the 2.0-mm locking group in favourable cases. Substance abuse occurred predominantly in the 2.0-mm locking group, in unfavourable and favourable fractures. There were more cases of complex fractures in the conventional group in unfavourable cases. One case involving a major postoperative complication occurred in the locking group (2.2%) and three cases occurred in the conventional group (7.1%) but with no significant difference between groups. In this study, there were no major differences between conventional and locking 2.0-mm locking systems with regard to the outcome of treated mandibular fractures, showing that both are adequate as long as the criteria of their indication and requirements for installation are met.
It was concluded that the 2.0-mm locking fixation system can replace conventional systems in the treatment of mandibular fractures; in addition, this approach was effective in the treatment of unfavourable fractures that typically require the 2.4-mm conventional system.
对2.0毫米锁定固定系统与传统系统在治疗下颌骨骨折中的应用进行比较研究。
在本研究中，87例连续的患有112处下颌骨骨折的患者被随机分为两组，分别接受2.0毫米锁定钢板治疗（n = 45）或传统的2.0或2.4毫米钢板治疗（n = 42），且至少随访6个月。骨折根据移位程度和复杂程度进行分类。当分别比较不利和有利病例时，采用统计分析来验证两组之间可能存在的差异（p≤0.050）。
尽管进行了随机分组，但在有利病例中，2.0毫米锁定组的全身性疾病更为常见。药物滥用主要发生在2.0毫米锁定组，包括不利和有利骨折的情况。在不利病例中，传统组的复杂骨折病例更多。锁定组发生1例严重术后并发症（2.2%），传统组发生3例（7.1%），但两组之间无显著差异。在本研究中，传统的2.0毫米锁定系统和锁定系统在治疗下颌骨骨折的结果方面没有重大差异，表明只要满足其适应证标准和安装要求，两者都是合适的。
得出的结论是，2.0毫米锁定固定系统可在治疗下颌骨骨折中替代传统系统；此外，这种方法在治疗通常需要2.4毫米传统系统的不利骨折方面是有效的。
