Hammer B, Schier P, Prein J
Clinic for Reconstructive Surgery, University Hospital Basel, Switzerland.
Br J Oral Maxillofac Surg. 1997 Aug;35(4):288-91. doi: 10.1016/s0266-4356(97)90050-4.
This article reviews 31 condylar neck fractures in 30 patients stabilized with different types of plates with emphasis on complications associated with different types of plates. Indications for stabilization were predominantly bilateral fractures, shortening of the ascending ramus due to lack of occlusal buttressing and condylar neck fractures associated with panfacial fractures. Stabilization was achieved with a single (23 fractures) or a double adaptation miniplate (4 fractures), a 2.4 mm plate (2 fractures) or a TMJ prosthesis (2 fractures). Eight fractures exhibited complications requiring reoperation (4 plate fractures, 3 cases of screw loosening associated with infection, 1 malposition). Complications occurred exclusively in the fractures stabilized with a single adaptation miniplate. Recommendations for stabilization, therefore, include a double miniplate, a 2.4 plate, a minidynamic compression plate (finger-plate) or a 2.0 mandibular-miniplate. Screws are preferably placed bicortically.
本文回顾了30例患者的31例髁突颈部骨折,这些骨折采用不同类型的钢板进行固定,重点关注与不同类型钢板相关的并发症。固定的适应证主要为双侧骨折、由于缺乏咬合支撑导致升支缩短以及与全面部骨折相关的髁突颈部骨折。采用单块(23例骨折)或双适应微型钢板(4例骨折)、2.4 mm钢板(2例骨折)或颞下颌关节假体(2例骨折)实现固定。8例骨折出现需要再次手术的并发症(4例钢板骨折、3例与感染相关的螺钉松动、1例位置不当)。并发症仅发生在用单适应微型钢板固定的骨折中。因此,固定的建议包括双微型钢板、2.4 mm钢板、微型动力加压钢板(指状钢板)或2.0下颌微型钢板。螺钉最好双皮质置入。