Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy.
Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
J Craniofac Surg. 2024 Jun 1;35(4):1120-1124. doi: 10.1097/SCS.0000000000010128. Epub 2024 May 7.
The training and preferences of surgeons influence the type of surgical treatment for mandibular fractures. This multicentre prospective study analyzed the current treatment strategies and outcomes for mandibular fractures with open reduction and internal fixation (ORIF).
This prospective study included patients aged ≥16 years who underwent ORIF for mandibular fractures in 12 European maxillofacial centers. Age, sex, pretrauma dental status, fracture cause, site and type, associated facial fractures, surgical approach, plate number and thickness (≤1.4 or ≥1.5 mm), duration of postoperative maxillomandibular fixation, occlusal and infective complications at 6 weeks and 3 months, and revision surgeries were recorded.
Between May 1, 2021 and April 30, 2022, 425 patients (194 single, 182 double, and 49 triple mandibular fractures) underwent ORIF for 1 or more fractures. Rigid osteosynthesis was performed for 74% of fractures and was significantly associated with displaced ( P =0.01) and comminuted ( P =0.03) fractures and with the number of nonsurgically treated fracture sites ( P =0.002). The angle was the only site associated with nonrigid osteosynthesis ( P <0.001). Malocclusions (5.6%) and infective complications (5.4%) were not associated with osteosynthesis type.
Rigid osteosynthesis was the most frequently performed treatment at all fracture sites, except the mandibular angle, and was significantly associated with displaced and comminuted fractures and the number of nonsurgically treated fracture sites. No significant differences were observed regarding postoperative malocclusion or infections among osteosynthesis types.
外科医生的培训和偏好影响下颌骨骨折的手术治疗类型。这项多中心前瞻性研究分析了经切开复位内固定（ORIF）治疗下颌骨骨折的当前治疗策略和结果。
这项前瞻性研究纳入了在 12 个欧洲颌面中心接受 ORIF 治疗下颌骨骨折的年龄≥16 岁的患者。记录了年龄、性别、外伤前的牙齿状况、骨折原因、部位和类型、伴发的面骨骨折、手术入路、接骨板数量和厚度（≤1.4 或≥1.5mm）、术后颌骨固定的持续时间、6 周和 3 个月时的咬合和感染并发症以及翻修手术。
在 2021 年 5 月 1 日至 2022 年 4 月 30 日期间，425 例（194 例单发性、182 例双发性和 49 例多发性下颌骨骨折）接受了 1 处或多处骨折的 ORIF。74%的骨折采用了刚性骨愈合，与移位（ P =0.01）和粉碎性（ P =0.03）骨折以及非手术治疗骨折部位的数量显著相关（ P =0.002）。角度是唯一与非刚性骨愈合相关的部位（ P <0.001）。咬合不正（5.6%）和感染并发症（5.4%）与骨愈合类型无关。
除下颌角外，刚性骨愈合是所有骨折部位最常采用的治疗方法，与移位和粉碎性骨折以及非手术治疗骨折部位的数量显著相关。在骨愈合类型方面，术后咬合不正或感染无显著差异。
