Worrall S F
Department of Oral and Maxillofacial Surgery, Leeds Dental Institute.
Br J Oral Maxillofac Surg. 1994 Oct;32(5):289-92. doi: 10.1016/0266-4356(94)90048-5.
To compare the changes in postoperative weight and body composition following orthognathic surgery or jaw fractures treated by intermaxillary fixation (IMF) or miniplate osteosynthesis.
A 4-month non-randomised prospective pilot study. Body composition was assessed using the 4 site skinfold thickness technique. The fixation method used in each case was dependent on clinical criteria alone.
Oral and maxillofacial surgery units at St James's University Hospital and the General Infirmary at Leeds.
All patients were eligible for inclusion in the study if they had sustained a jaw fracture or had undergone orthognathic surgery. Patients were excluded if they had sustained polytrauma, if their sole orthognathic surgery procedure was a genioplasty and if the author was not directly involved in their management. The final study group consisted of 22 patients, 18 following surgical correction of jaw fractures and 4 following elective orthognathic surgery. Thirteen patients were managed with intermaxillary fixation and 9 patients were treated with miniplate osteosynthesis.
Weight, lean body mass, total body water, fat and water free lean body mass, 1 week and 6 weeks postoperatively.
There was no significant difference in weight loss or body composition changes between the plated and non plated groups at 1 week postoperatively. However, by 6 weeks postoperatively the IMF group had lost significantly more weight (4.5 kg) than the plated group (1.1 kg). In the plated group this weight loss resulted entirely from a loss of lean body mass (77% water), whereas in the other group it resulted from a fat loss of 1.2 kg plus a lean body mass loss of 3.3 kg (73% water). Estimated protein losses were 0.9 kg for the IMF group and 0.3 kg for the plated group.
Intermaxillary fixation compromises nutritional status in the early postoperative period leading to loss of water, fat and protein. The results of this pilot study suggest that further investigation of postoperative weight and body composition changes after oral and maxillofacial operations is indicated.
比较正颌手术或采用颌间固定（IMF）或微型钢板内固定治疗颌骨骨折术后体重和身体成分的变化。
一项为期4个月的非随机前瞻性试验研究。采用四处皮褶厚度技术评估身体成分。每种情况下使用的固定方法仅取决于临床标准。
圣詹姆斯大学医院和利兹综合医院的口腔颌面外科病房。
所有颌骨骨折或接受正颌手术的患者均符合纳入本研究的条件。如果患者遭受多发伤、其唯一的正颌手术为颏成形术以及作者未直接参与其治疗，则将其排除。最终研究组由22例患者组成，其中18例为颌骨骨折手术矫正后患者，4例为择期正颌手术后患者。13例患者采用颌间固定治疗，9例患者采用微型钢板内固定治疗。
术后1周和6周时的体重、瘦体重、总体水、脂肪及去脂瘦体重。
术后1周时，钢板固定组和非钢板固定组在体重减轻或身体成分变化方面无显著差异。然而，术后6周时，颌间固定组体重减轻（4.5千克）显著多于钢板固定组（1.1千克）。在钢板固定组，体重减轻完全是由于瘦体重（77%为水）的减少，而在另一组，体重减轻是由于1.2千克脂肪减少加上3.3千克瘦体重（73%为水）减少。颌间固定组估计蛋白质损失为0.9千克，钢板固定组为0.3千克。
颌间固定在术后早期会影响营养状况，导致水、脂肪和蛋白质流失。这项试验研究结果表明，有必要进一步研究口腔颌面手术后体重和身体成分的变化。
