Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
J Craniomaxillofac Surg. 2020 Aug;48(8):756-764. doi: 10.1016/j.jcms.2020.06.001. Epub 2020 Jun 16.
The aim of this study was to examine two different types of three-dimensional plate for their suitability for the treatment of condylar neck and base fractures, and to evaluate the most frequent complications, while considering three different surgical approaches.
This retrospective study was conducted in patients who received two different types of three-dimensional plate for the treatment of condylar neck and base fractures, using three different surgical approaches, from January 2016 to December 2018. Medical records were obtained during an average follow-up period of 9 months after the traumatic event, with data collected on factors affecting success and failure of miniplates, clinical outcome parameters, and complications.
A total of 43 fractures (38 patients) were examined. No differences were found between the two plate designs (mean = 0.093, SD = 0.294, p = 0.562). All fractures achieved complete bone healing, but in four cases, a revision operation had to be performed. No significant complications were found regardless of the surgical approaches chosen. There was no correlation between plate system (mean = 0.419, SD = 0.492, p = 0.497) or surgical access (mean = 0.163, SD = 0.432, p = 0.247) and the occurrence of facial nerve palsy found. Due to the extraoral approach used, permanent facial nerve palsy was reported in one case. With the intraoral approach, one case of transient facial paresis was observed. No facial palsy was observed in patients treated via a preauricular approach.
Deltoid and trapezoid plates seem to perform equally in the treatment of condylar neck and base fractures.
本研究旨在检验两种不同类型的三维接骨板治疗髁颈和髁基骨折的适用性,并评估最常见的并发症,同时考虑三种不同的手术入路。
本回顾性研究纳入了 2016 年 1 月至 2018 年 12 月期间因髁颈和髁基骨折接受两种不同类型三维接骨板治疗且采用三种不同手术入路的患者。在创伤后平均 9 个月的随访期间获取病历,收集影响微型板成功和失败的因素、临床结果参数和并发症的数据。
共检查了 43 处骨折(38 例患者)。两种接骨板设计之间无差异(均值=0.093,标准差=0.294,p=0.562)。所有骨折均完全愈合,但有 4 例需要进行翻修手术。无论选择何种手术入路,均未发现明显并发症。接骨板系统(均值=0.419,标准差=0.492,p=0.497)或手术入路(均值=0.163,标准差=0.432,p=0.247)与面神经麻痹的发生之间均无相关性。由于采用了经口外入路,1 例发生永久性面神经麻痹。经口内入路观察到 1 例暂时性面瘫。经耳前入路治疗的患者均未发生面瘫。
三角和梯形板在治疗髁颈和髁基骨折方面似乎具有相同的效果。