Söderholm A L, Hallikainen D, Lindqvist C
Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Finland.
Arch Otolaryngol Head Neck Surg. 1993 Sep;119(9):1031-6. doi: 10.1001/archotol.1993.01880210121017.
To evaluate the benefits of narrow-beam roentgenography and spiral tomography for examination and monitoring of screw and plate fixation to bone we studied 22 rigid plate bridgings of mandibular defects. The plate reconstructions were of long duration or considered permanent. In 13 patients, AO-THORP (AO: Arbeitsgemeinschaft für Osteosynthesefragen; THORP: Titanplasma-beschichteten Hohl- und Vollkern-Rekonstruktionsplatten-Systems) reconstructions were used and in nine classic AO stainless steel plate bridgings. With the AO-THORP system, good bone apposition to the screws was evident in 96% (73/76 screws) of the cases. Fixation using the classic AO screws, however, was inadequate in 30% (20/66 screws) of the cases. Plate loosening was noted in 56% (5/9 plates). Examination using narrow-beam roentgenography and spiral tomography provided detailed information about bone resorption around the screws and provided a reliable tool for deciding on a follow-up regimen. When complications occur, they can be detected and treated early, reducing patient morbidity. In our opinion, classic AO plate bridging should always be considered temporary.
为评估窄束X线摄影术和螺旋断层扫描术在检查和监测螺钉及钢板固定于骨组织方面的益处，我们研究了22例下颌骨缺损的刚性钢板桥接术。钢板重建时间长或被视为永久性的。13例患者采用AO-THORP（AO：骨科学问题研究协会；THORP：钛等离子涂层空心和实心核重建钢板系统）重建，9例采用经典AO不锈钢钢板桥接。使用AO-THORP系统时，96%（76颗螺钉中的73颗）的病例中螺钉与骨的贴合良好。然而，使用经典AO螺钉固定时，30%（66颗螺钉中的20颗）的病例固定不充分。56%（9块钢板中的5块）出现钢板松动。使用窄束X线摄影术和螺旋断层扫描术进行检查可提供有关螺钉周围骨吸收的详细信息，并为确定随访方案提供可靠工具。当出现并发症时，可早期发现并治疗，降低患者发病率。我们认为，经典AO钢板桥接术应始终被视为临时性的。
