Chen Chien-Chung, Chiu Ting-Han, Yan Cheng-Yu, Hou Ya-Pei, Lin Ting-Sheng
Department of Plastic and Reconstructive Surgery, E-Da Hospital, Kaohsiung City 82445, Taiwan.
College of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan.
Bioengineering (Basel). 2024 Jul 11;11(7):704. doi: 10.3390/bioengineering11070704.
The open reduction of mandibular condyle neck fractures is difficult due to the limited surgical field and complex facial nerve structures. The most effective fixation method for narrow fractured segments is debated as standard double four-hole plate fixation is often not feasible. This research compared bone stability and force resistance between single-long-plate and double-short-plate fixations using clinical outcomes, a Sawbones mandible model, and finite element analysis. In patients with condyle neck fractures, nine were fixed with single-long-plate and twelve with double-short-plate fixations, with no significant differences in malocclusion and facial palsy rates. In compression tests with a Sawbones model, displacements in the posterior part were similar in both fixation groups. In contrast, the anterior part had significantly higher displacements in the single-long-plate group. Finite element analysis showed higher displacements in both anterior and posterior parts in the single-plate group compared to the double-short-plate group. Maximum stresses were at the second screw hole in single-long-plate fixation and the turning point of the upper plate at the condyle neck in double-short-plate fixation. Double-short-plate fixations demonstrated better stability and force resistance than single-long-plate fixations.
由于手术视野有限和面部神经结构复杂，下颌髁突颈部骨折的切开复位术具有一定难度。对于狭窄骨折段，最有效的固定方法存在争议，因为标准的双四孔钢板固定通常不可行。本研究通过临床结果、Sawbones下颌骨模型和有限元分析，比较了单长钢板固定和双短钢板固定之间的骨稳定性和抗阻力。在髁突颈部骨折患者中，9例采用单长钢板固定，12例采用双短钢板固定，错牙合畸形和面神经麻痹发生率无显著差异。在Sawbones模型的压缩试验中，两个固定组后部的位移相似。相比之下，单长钢板组前部的位移明显更高。有限元分析表明，与双短钢板组相比，单钢板组的前部和后部位移均更高。单长钢板固定时最大应力出现在第二个螺孔处，双短钢板固定时最大应力出现在髁突颈部上板的转折点处。双短钢板固定比单长钢板固定表现出更好的稳定性和抗阻力。
