Department for Oral and Craniomaxillofacial Plastic Surgery, University of Cologne, Cologne, Germany.
Department for Oral and Craniomaxillofacial Plastic Surgery, University of Cologne, Cologne, Germany.
J Craniomaxillofac Surg. 2018 Apr;46(4):566-572. doi: 10.1016/j.jcms.2018.01.003. Epub 2018 Feb 2.
Mandibulo-maxillary fixation (MMF) is indispensable for mandibular fracture treatment. Various means for MMF have been proposed, of which arch bars are widely considered to be the mainstay. However, disadvantages to this method have initiated a quest for an alternative, leading to the introduction of MMF screws. MMF screws have frequently been criticized for poor stability of fracture sites, root damage, hardware failure, and nerve damage. We retrospectively evaluate the FAMI (Fixation and Adaptation in Mandibular Injuries) screw in mandibular fracture treatment by scanning for clinically and radiologically visible complications. In total, 534 FAMI screws were used in the successful treatment of 96 males and 34 females. Condylar fractures were most commonly encountered, representing 120 of 241 fracture sites. 15 general fracture-related complications occurred, with the most common being nerve function impairment (3.8%) and postoperative malocclusion (4.6%). In nine cases (7%), clinically visible FAMI-screw-related complications occurred, with the most prevalent being screw loosening (2.3%) and mucosal signs of inflammation (3.1%). Duration of FAMI screws was associated with the occurrence of clinically visible complications (p = 0.042). Radiologically, clinically invisible dental hard tissue damage was noted in 21 individuals (16%). Therefore, FAMI screws seem to be a reliable and safe method for mandibulo-maxillary fixation.
颌骨固定（MMF）对于下颌骨骨折的治疗是必不可少的。已经提出了各种用于 MMF 的方法，其中弓条被广泛认为是主要方法。然而，这种方法的缺点促使人们寻求替代方法，从而引入了 MMF 螺钉。MMF 螺钉经常因骨折部位稳定性差、根损伤、硬件故障和神经损伤而受到批评。我们通过扫描临床和影像学可见的并发症来回顾性评估下颌骨骨折治疗中的 FAMI（下颌骨损伤的固定和适应）螺钉。共有 534 枚 FAMI 螺钉用于成功治疗 96 名男性和 34 名女性。髁突骨折最常见，241 个骨折部位中有 120 个。发生了 15 例一般骨折相关并发症，最常见的是神经功能障碍（3.8%）和术后咬合不正（4.6%）。在 9 例（7%）中，出现了临床可见的 FAMI 螺钉相关并发症，最常见的是螺钉松动（2.3%）和粘膜炎症迹象（3.1%）。FAMI 螺钉的持续时间与临床可见并发症的发生有关（p=0.042）。在 21 名个体中（16%），放射学上注意到了临床不可见的牙硬组织损伤。因此，FAMI 螺钉似乎是一种可靠且安全的颌骨固定方法。
