Schmoker R, Tschopp H M
Helv Chir Acta. 1979 May;46(1-2):39-45.
The therapy of facial fractures is aimed at an early definitive treatment. Exact repositioning of the fragments is first achieved by setting the right occlusion. Intermaxillary fixation is then performed by interdental arch bars reenforced with acrylic material and intermaxillary rubber bands or wire. The middle third of the face is mainly subjected to static forces. Fractures in this area are therefore set and fixated with interosseous wire ligatures. Craneofacial suspension is carried out by means of a craneofixateur extern. Fractures of the mandible are treated differently. In order to counteract the strong dynamic forces internal fixation is necessary using compression plates in combination with tension bands. Another modality of treatment by a specially designed plate with excentric gliding holes renders the tension bands superfluous since it is capable of applying compression forces also at the dental area. In fractures with osseous defects long plates are used which stabilize the mandibular arch. If the articular prominence is missing these plates may be applied with a capitular end in order to reconstruct the articulation.
面部骨折的治疗旨在进行早期确定性治疗。首先通过建立正确的咬合关系来实现骨折碎片的精确复位。然后通过用丙烯酸材料加固的牙间弓杆以及颌间橡皮筋或钢丝进行颌间固定。面部中三分之一主要承受静力。因此,该区域的骨折采用骨间钢丝结扎进行复位和固定。颅面悬吊通过颅外固定器进行。下颌骨骨折的治疗方法不同。为了对抗强大的动力,需要使用加压板结合张力带进行内固定。另一种治疗方式是使用带有偏心滑动孔的特殊设计钢板,由于它也能够在牙区施加压缩力,因此无需张力带。在存在骨缺损的骨折中,使用长钢板来稳定下颌弓。如果关节突缺失,这些钢板可带有小头端应用,以重建关节。