Uglesić V, Virag M, Aljinović N, Macan D
Department of Maxillofacial and Oral Surgery, School of Medicine, School of Dentistry, University of Zagreb, Croatia.
J Craniomaxillofac Surg. 1993 Sep;21(6):251-7. doi: 10.1016/s1010-5182(05)80042-3.
A total of 124 patients treated for mandibular fractures were analyzed. Patients were divided into three groups according to treatment: intermaxillary fixation, wire fixation and mini-plate fixation. For each method, the success of treatment was evaluated with respect to surgical approach, fracture site and injury to treatment interval. Five basic parameters were used for evaluation of the outcome: occlusion, appearance, mastication, duration of IMF and complications. The treatment was surveyed based on both the surgeon's and patient's-evaluation. All parameters were scored and average values for every parameter calculated. The most successful treatment was achieved with mini-plate fixation in symphyseal and angle fractures. Intermaxillary fixation is indicated for mandibular body fractures with or without minimal displacement and a sufficient number of teeth. However, mini-plate fixation should be used for fractures with displacement. Wire fixation has been shown to be the poorest choice for all sites. Results showed that the intraoral approach has advantages over the extraoral one. The optimal time for treatment of mandibular fractures is within 72 h from time of injury. Even in fractures older than 7 days we recommended mini-plate fixation.
共分析了124例接受下颌骨骨折治疗的患者。根据治疗方法将患者分为三组：颌间固定、钢丝固定和微型钢板固定。对于每种方法，从手术入路、骨折部位和受伤至治疗间隔时间方面评估治疗的成功率。采用五个基本参数评估治疗结果：咬合、外观、咀嚼、颌间固定持续时间和并发症。基于外科医生和患者的评估对治疗进行调查。对所有参数进行评分并计算每个参数的平均值。在颏部和角部骨折中，微型钢板固定取得了最成功的治疗效果。颌间固定适用于有或无轻微移位且有足够数量牙齿的下颌骨体部骨折。然而，对于有移位的骨折应采用微型钢板固定。已表明钢丝固定是所有部位最不理想的选择。结果显示，口内入路比口外入路具有优势。下颌骨骨折的最佳治疗时间是受伤后72小时内。即使是受伤超过7天的骨折，我们也建议采用微型钢板固定。
