Ellis E, Walker L
Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9109.
J Oral Maxillofac Surg. 1994 Oct;52(10):1032-6; discussion 1036-7. doi: 10.1016/0278-2391(94)90169-4.
To evaluate treatment with two 2.0-mm noncompression miniplates for patients with angle fractures.
Sixty-seven consecutive patients with 69 fractures of the mandibular angle were treated by open reduction and internal fixation using two noncompression miniplates and 2.0-mm self-threading screws placed through a transoral incision with transbuccal trochar instrumentation. No patient was placed into postsurgical maxillomandibular fixation or elastics.
Overall, 19 fractures (28%) experienced complications requiring secondary surgical intervention. Most of the complications were postoperative infections requiring surgical drainage (n = 17) and subsequent hardware removal (n = 16). Of the 17 infected fractures, 11 were healed at the time of hardware removal and required no further treatment. Five were still mobile and required a period of maxillomandibular fixation for healing. One of the fractures did not heal and required bone grafting.
The use of two noncompression miniplates was found to be relatively easy, but resulted in an unacceptable rate of infection in our patient population when used for treatment of fractures of the mandibular angle.
评估使用两块2.0毫米非加压微型钢板治疗下颌角骨折患者的效果。
67例连续患者共69处下颌角骨折，采用经口内切口及经颊套管器械置入两块非加压微型钢板和2.0毫米自攻螺钉进行切开复位内固定治疗。术后未对任何患者进行颌间固定或使用弹力牵引。
总体而言，19处骨折（28%）出现需要二次手术干预的并发症。大多数并发症为术后感染，需要手术引流（n = 17）及随后取出内固定物（n = 16）。在17处感染骨折中，11处在取出内固定物时已愈合，无需进一步治疗。5处仍有活动，需要一段时间的颌间固定以促进愈合。1处骨折未愈合，需要植骨。
发现使用两块非加压微型钢板相对容易，但在我们的患者群体中用于治疗下颌角骨折时，感染率令人无法接受。
