Choi Jong-Woo, Kim Hyung Bae, Jeong Woo Shik, Kim Sung Chan, Koh Kyung S
Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Craniofac Surg. 2019 Sep;30(6):1787-1789. doi: 10.1097/SCS.0000000000005488.
Intermaxillary fixation (IMF) using the arch bar has been the standard technique for a long time in the management of mandibular fracture. But because of several complications, intermaxillary fixation with screws has been introduced and adopted to use. This investigation compared the outcomes and complications between the traditional IMF and modified intermaxillary fixation with screws techniques in terms of the malocclusion, surgical time, root injury, and screw or arch bar failure.
This retrospective review included 66 patients who underwent reconstruction of mandibular fractures that uses traditional arch bar or IMF screws as IMF. Preoperative and postoperative facial bone computed tomography, panoramic x-ray were used to evaluate the patients. The complaints and complications were recorded in electric medical record based on patients' consultation during follow-up.
The total complication rate was no higher using anchoring screw as an IMF than using arch bar fixation as an IMF. Mean surgical time was significantly shorter in the anchoring screw group than arch bar fixation (111 versus 157 min; P < .05). After compensation of the number of fracture sites, there was a significant difference in operation time (linear regression model, P = .009).
This investigation revealed that the IMF using IMF screw systems could be a good alternative for the management of mandibular fracture. It could minimize the whole operation time with the similar complication ratio.
长期以来,使用牙弓夹板进行颌间固定(IMF)一直是治疗下颌骨骨折的标准技术。但由于存在多种并发症,已引入并采用了螺钉颌间固定技术。本研究比较了传统颌间固定与改良螺钉颌间固定技术在错牙合、手术时间、牙根损伤以及螺钉或牙弓夹板失败方面的治疗效果和并发症情况。
这项回顾性研究纳入了66例接受下颌骨骨折重建手术的患者,这些患者采用传统牙弓夹板或螺钉颌间固定作为颌间固定方法。术前和术后使用面部骨计算机断层扫描、全景X线片对患者进行评估。根据患者随访期间的咨询情况,将主诉和并发症记录在电子病历中。
使用锚固螺钉作为颌间固定的总并发症发生率并不高于使用牙弓夹板固定作为颌间固定的情况。锚固螺钉组的平均手术时间明显短于牙弓夹板固定组(111分钟对157分钟;P<0.05)。在对骨折部位数量进行补偿后,手术时间存在显著差异(线性回归模型,P=0.009)。
本研究表明,使用颌间固定螺钉系统进行颌间固定可能是治疗下颌骨骨折的一种良好替代方法。它可以在并发症发生率相似的情况下将整个手术时间减至最短。