Tuovinen V, Nørholt S E, Sindet-Pedersen S, Jensen J
Department of Oral and Maxillofacial Surgery, Aarhus University, Denmark.
J Oral Maxillofac Surg. 1994 Sep;52(9):931-5; discussion 935-6. doi: 10.1016/s0278-2391(10)80072-2.
This article addresses the suitability of semirigid fixation for the treatment of mandibular fractures.
Between 1986 and 1991, 279 patients with 447 isolated mandibular fractures were treated with miniplate fixation using the tension-band principle of Champy et al. The time from trauma to treatment, etiology, number and location of the fractures, and the presence of preoperative infection and neurosensory disturbances were recorded. Postoperative complications such as infections, neurosensory disturbances, malocclusion, and nonunions also were recorded, as well as the reasons for removal of the miniplates.
Postoperative infection occurred in 10 patients (3.6%). These infections were controlled by antibiotics and the miniplates were removed after the acute phase. Occlusion disturbances were noted postoperatively in 13 patients (4.7%), and they were corrected by minimal occlusal grinding in the majority of cases. Neurosensory disturbances were noted preoperatively in 26.9% of the patients and 12 months postoperatively in 1.4% of the patients. Forty-seven plates (8.1%) in 32 patients (11.5%) were removed for a variety of reasons. No cases of nonunion occurred.
Semirigid fixation of mandibular fractures with miniplates is a viable treatment option for the management of such injuries.
本文探讨半坚固内固定治疗下颌骨骨折的适用性。
1986年至1991年间，279例患者共447处孤立性下颌骨骨折采用Champy等人的张力带原理行微型钢板内固定治疗。记录从受伤到治疗的时间、病因、骨折的数量和部位，以及术前感染和神经感觉障碍的情况。还记录了术后并发症，如感染、神经感觉障碍、咬合不正和骨不连，以及取出微型钢板的原因。
10例患者（3.6%）发生术后感染。这些感染通过抗生素得到控制，急性期过后取出微型钢板。13例患者（4.7%）术后出现咬合紊乱，大多数病例通过轻微的咬合磨改得以纠正。26.9%的患者术前出现神经感觉障碍，术后12个月1.4%的患者出现神经感觉障碍。32例患者（11.5%）中的47块钢板（8.1%）因各种原因被取出。未发生骨不连病例。
微型钢板半坚固内固定是治疗下颌骨骨折的一种可行方法。
