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一项关于下颌前部骨折切开复位后使用拉力螺钉和微型钢板进行骨合成的临床前瞻性随机对照研究。

A clinical prospective randomized comparative study on ostyeosynthesis of mandibular anterior fractures following open reduction using lag screws and miniplates.

作者信息

Mittal Gaurav, Aggrawal Anmol, Garg Ritesh, Sharma Siddharth, Rathi Abhishek, Sharma Vishnu

机构信息

Department of OMFS, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India.

出版信息

Natl J Maxillofac Surg. 2017 Jul-Dec;8(2):110-116. doi: 10.4103/njms.NJMS_38_17.

Abstract

INTRODUCTION

The aim of the present study was to compare fixation of mandibular anterior fractures following open reduction using lag screws or miniplates.

MATERIALS AND METHODS

This prospective study was conducted on 20 patients diagnosed with cases of displaced mandibular anterior fractures treated with open reduction and internal fixation. The patients were then randomly allocated to either of two groups - Group A: two 2.5 mm stainless steel lag screws were placed in 10 patients. Group B: two 2.5 mm miniplates were placed in 10 patients for the fixation of fractures. Subsequent follow-up was done on the 1 day, 1, 4, and 36 week postoperatively. During every follow-up, patient was assessed clinically for infection, malocclusion, loosening of plate/screw, malunion/nonunion, and masticatory efficiency. Radiographs (orthopantogram) were taken preoperative, 1, 4, and 36 postoperative week to compare the osteosynthesis between the two groups. Pain was objectively measured using a visual analog scale. The data collected was subjected to unpaired -test and paired -test for statistical analysis.

RESULT

It was found that lag screw placement was rapid in comparison of miniplate placement. 3rd month postoperative assessment revealed Lag screw group to have better biting efficiency, and better bone healing which was statistically significant when compared with miniplate group.

CONCULSION

Our study suggests that lag screw osteosynthesis can be advocated as a valid treatment modality in the management of mandibular symphysis and parasymphysis fractures.

摘要

引言

本研究的目的是比较使用拉力螺钉或微型钢板切开复位后下颌前部骨折的固定情况。

材料与方法

本前瞻性研究对20例诊断为下颌前部移位骨折并行切开复位内固定治疗的患者进行。然后将患者随机分为两组——A组:10例患者植入两枚2.5毫米不锈钢拉力螺钉。B组:10例患者植入两枚2.5毫米微型钢板用于骨折固定。术后第1天、1周、4周和36周进行随访。每次随访时,对患者进行临床评估,检查是否有感染、咬合不正、钢板/螺钉松动、骨不连/骨愈合不良以及咀嚼效率。术前、术后第1周、4周和36周拍摄口腔全景X线片,以比较两组的骨接合情况。使用视觉模拟量表客观测量疼痛程度。对收集的数据进行非配对t检验和配对t检验以进行统计分析。

结果

发现与植入微型钢板相比,植入拉力螺钉速度更快。术后第3个月的评估显示,拉力螺钉组的咬合效率更高,骨愈合更好,与微型钢板组相比具有统计学意义。

结论

我们的研究表明,拉力螺钉骨接合术可作为下颌联合部和下颌旁联合部骨折治疗的一种有效治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d887/5773984/cdf95c21c638/NJMS-8-110-g001.jpg

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