From the Department of Maxillofacial Surgery, Royal Brisbane and Women's Hospital.
Maxillofacial Surgery Unit, Princess Alexandra Hospital.
Plast Reconstr Surg. 2024 Oct 1;154(4):737e-744e. doi: 10.1097/PRS.0000000000011103. Epub 2023 Sep 29.
Fractures involving the bilateral mandibular angle are an uncommon occurrence with limited evidence to inform the ideal fixation requirements for adequate treatment. The aim of this study was to evaluate the outcomes of managing bilateral mandibular angle fractures and determine whether rigid fixation on 1 side improves outcomes compared with bilateral nonrigid fixation.
Patients with isolated bilateral mandibular angle fractures treated surgically at the Royal Brisbane and Women's Hospital, Princess Alexandra Hospital, Gold Coast University Hospital, and Townsville University Hospital between January 1, 2010, and December 31, 2022, were identified retrospectively. Data collected included patient demographics, mechanism of injury, fixation scheme, postoperative occlusion, and the occurrence of postoperative complications and subsequent management.
Eighty-four patients met the inclusion criteria. Fifty-two patients had nonrigid fixation applied to both fractures, and 32 had rigid fixation placed on at least 1 side. All cases proceeded to union. There was no statistically significant difference between the groups for occlusal outcomes, wound dehiscence, infection, or plate or screw loosening.
The authors' results suggest that bilateral nonrigid fixation can be used to treat bilateral mandibular angle fractures in the appropriate clinical context.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
双侧下颌角骨折较为少见，相关治疗的理想固定要求证据有限。本研究旨在评估双侧下颌角骨折的治疗结果，并确定单侧刚性固定是否优于双侧非刚性固定。
回顾性分析 2010 年 1 月 1 日至 2022 年 12 月 31 日期间在皇家布里斯班和妇女医院、亚历山德拉公主医院、黄金海岸大学医院和汤斯维尔大学医院接受手术治疗的孤立性双侧下颌角骨折患者。收集的数据包括患者人口统计学资料、损伤机制、固定方案、术后咬合情况以及术后并发症的发生和后续处理。
84 例患者符合纳入标准。52 例患者双侧骨折采用非刚性固定，32 例至少一侧采用刚性固定。所有病例均愈合。两组在咬合结果、伤口裂开、感染或钢板或螺钉松动方面无统计学差异。
作者的结果表明，在适当的临床情况下，双侧非刚性固定可用于治疗双侧下颌角骨折。
临床问题/证据水平：治疗性，III 级。
