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皮质骨拉力螺钉固定术治疗下颌骨损伤

Cortical lag screw fixation for the management of mandibular injuries.

作者信息

Elsayed Shadia Abdel-Hameed

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt.

Department of Oral and Maxillofacial Surgery, Taibah University Dental College & Hospital, Al-Madinah Al-Munawwarah, Saudi Arabia.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2020 Dec 31;46(6):393-402. doi: 10.5125/jkaoms.2020.46.6.393.

Abstract

OBJECTIVES

Here, we present cases of mandibular fracture that were managed with the cortical lag screw fixation technique (CLSFT) in order to critically evaluate technique indications and limitations of application at various fracture sites.

MATERIALS AND METHODS

This was a retrospective cohort study. The study sample was composed of patients suffering from mandibular fractures that were treated by the CLSFT. The outcome variables were fracture type, duration of surgery, number of screws, and pattern of application. Other study categories included patient demographics and causes of injury. Chi-square tests were used to assess descriptive and inferential statistical differences, and the -value was set at 0.05.

RESULTS

Thirty-three patients were included in the study sample, with a mean age of 30.9±11.5 years and a male predominance of 81.8%. The technique was applied more frequently in the anterior mandibular region (51.5%) than in other sites. Double CLSFT screws were required at the symphysis and parasymphysis, while single screws were used for body and angle regions. No intraoperative and postoperative variables were significantly different except for surgical duration, which was significantly different between the sites studied (=0.035).

CONCLUSION

We found that CLSFT is a rapid, cost-effective technique for the fixation of mandibular fractures yielding good treatment results and very limited complications. However, this technique is sensitive and requires surgical expertise to be applied to mandibular fractures that have specialized characteristics.

摘要

目的

在此,我们展示采用皮质骨拉力螺钉固定技术(CLSFT)治疗下颌骨骨折的病例,以便严格评估该技术在不同骨折部位的应用指征和局限性。

材料与方法

这是一项回顾性队列研究。研究样本由接受CLSFT治疗的下颌骨骨折患者组成。观察变量包括骨折类型、手术时长、螺钉数量及应用方式。其他研究类别包括患者人口统计学资料和受伤原因。采用卡方检验评估描述性和推断性统计差异,设定P值为0.05。

结果

研究样本纳入33例患者,平均年龄30.9±11.5岁,男性占比81.8%。该技术在前下颌区域(51.5%)的应用频率高于其他部位。在正中联合和正中旁区域需要使用双皮质骨拉力螺钉,而体部和角部区域使用单枚螺钉。除手术时长外,术中及术后各变量无显著差异,手术时长在各研究部位之间存在显著差异(P = 0.035)。

结论

我们发现皮质骨拉力螺钉固定技术是一种快速、经济有效的下颌骨骨折固定技术,治疗效果良好且并发症极少。然而,该技术较为敏感,应用于具有特殊特征的下颌骨骨折时需要手术专业知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/875e/7783183/dc251a05d9d8/jkaoms-46-393-f1.jpg

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