Luhr H G, Hausmann D F
Kieferchirurgische Abteilung, Klinikum der Universität, Göttingen.
Fortschr Kiefer Gesichtschir. 1996;41:77-80.
A series of 922 fractures of the mandibular body (median-paramedian, horizontal ramus and mandibular angle) was treated within a 10 years period from January 1984 to December 1993 by an uniform treatment method. It consisted of compression plating with bicortical screw anchorage and intraoral approach, thus avoiding any outer scar and facial nerve damage. Postoperatively intermaxillary fixation was not used in any of these cases. A solid bony union was achieved in more than 99% of the cases. Major complications as osteomyelitis and non union were observed in 8 cases (0.86%). Minor complications of soft tissue infections without interference of fracture healing as haematomas, soft tissue abscesses and suture dehiscence were observed in 6.1%. A separate analysis of 352 mandibular angle fractures, which are regarded as particularly problematic, showed a frequency of severe complications (osteomyelitis and nonunion) of 0.85%. This is comparable with the frequency of complications of 0.86% within the total series. In this largest series of compression plating via intraoral approach, which has ever been published, the technique again has proved its significance as a standard procedure for the treatment of mandibular fractures.
1984年1月至1993年12月的10年间,采用统一的治疗方法治疗了922例下颌骨体部(正中-旁正中、水平支和下颌角)骨折。治疗方法包括双皮质螺钉固定加压钢板内固定及口内入路,从而避免了任何外部瘢痕和面神经损伤。所有病例术后均未采用颌间固定。超过99%的病例实现了牢固的骨愈合。观察到8例(0.86%)出现骨髓炎和骨不连等主要并发症。6.1%的病例出现了不影响骨折愈合的软组织感染等轻微并发症,如血肿、软组织脓肿和缝线裂开。对352例被认为特别棘手的下颌角骨折进行单独分析,结果显示严重并发症(骨髓炎和骨不连)的发生率为0.85%。这与整个系列中0.86%的并发症发生率相当。在这一有史以来发表的最大规模的口内入路加压钢板固定系列研究中,该技术再次证明了其作为下颌骨骨折治疗标准术式的重要性。