下颌骨多发性骨折治疗的临床观察

目的：探讨下颌骨多发性骨折的临床特点及治疗措施。方法：对9例下颌骨多发性骨折病例,根据骨折类型采用切开复位坚强内固定术配合术前或术后颌间牵引治疗或仅行颌间牵引进行治疗。术后1个月、6个月、1年随访,拍摄曲面断层片或CT复查骨折复位愈合情况并检查咬合关系。结果：9例下颌骨多发性骨折病例切口均一期愈合,骨折复位,愈合良好,9例咬合关系恢复正常。结论：下颌骨多发性骨折根据骨折类型选择合理治疗方式,坚强内固定联合术后短期颌间牵引,对保持骨折复位愈合、咬合关系恢复具有重要作用。     

颌面部多发性骨折的临床治疗分析

目的探讨颌面部多发性、复杂性骨折的治疗策略。方法应对非陈旧性的颌面部多发性骨折,联合神经外科、眼科、耳鼻喉科进行会诊,制定合理手术治疗方案。在骨折复位和固定治疗中,联合应用颌间结扎、钛板坚固内固定、皮瓣修复等多种技术,尽可能恢复患者的功能和面容外观。结果本组45例患者均在伤情稳定后进行骨折的整复治疗,对41处上颌骨骨折,33处下颌骨骨折,14处鼻骨骨折,12处髁突骨折,6处眶壁骨折,5处颧骨骨折进行复位和固定。术后随访3～12个月,骨折复位良好,效果满意。结论多临床学科的协同诊治有利于为患者提供更好的治疗,根据骨折的具体情况,合理选择适当的切口入路和结扎、固定方式,是颌面部多发性复杂骨折的有效治疗方法。     

下颌骨粉碎性骨折的治疗探讨

目的:探讨下颌骨粉碎性骨折的临床特征及治疗方法。方法:分析总结22例下颌骨粉碎性骨折患者的临床信息、治疗方法及随访结果。结果:22例患者共30处骨折,粉碎性骨折部位均只有一个,大都合并全身其它部位损伤。14例于4周内手术,21例采用坚强内固定,绝大多数患者术后获得了满意的面型和下颌功能恢复。结论:以重建钛板作坚强内固定是下颌骨粉碎性骨折首选治疗方法,以小型钛板或钛网固定+术后颌间固定2～3周、单纯颌间固定等是该方法的必要补充。术式的选择受到患者骨折严重程度、全身情况、术者的操作经验等因素的影响。     

自攻颌间牵引钉配合小型钛板治疗下颌骨骨折的疗效观察

目的:探讨自攻颌间牵引钉配合小型钛板治疗下颌骨骨折的临床疗效。方法:对48例下颌骨骨折患者采用自攻颌间牵引钉联合小型钛板行坚强内固定术。术后对患者的切口愈合情况、张口度、咬合关系、口腔卫生情况以及骨折愈合情况进行观察。结果:48例患者手术切口均为I期愈合,治疗效果满意,咬合关系良好,3个月后影像学复查示骨折线对位良好。结论:自攻颌间牵引钉配合小型钛板坚固内固定治疗下颌骨骨折是目前治疗下颌骨骨折较为理想的方法。     

面中部复杂性骨折的治疗

目的：探讨在面中部骨折治疗中更加有效地恢复咬He关系及面部形态。方法：切开复位坚固内固定23例。结果：本组患者术后形态和功能恢复良好。结论：面中部多发性骨折治疗中咬He关系的恢复应先行恢复下颌骨下颌骨的连续和颌平面,以此为标准恢复上颌及咬He关系;面部形态恢复应以上水平弓,鼻颌柱、翼颌柱的恢复为基础,力求使面部两侧及高度在三维空间结构上协调一致。     

下颌骨骨折1741例临床治疗分析

目的:探讨下颌骨骨折的临床特点及其治疗过程中的相关问题。方法:对1741例下颌骨骨折发生的年龄、性别、原因、并存伤、骨折类型、治疗及手术并发症进行回顾性总结分析。结果:下颌骨骨折男性多发,20～40岁为好发年龄段;交通事故伤为原因之首,骨折部位以颏部最多见;34.95%的伤员并存有面中部骨折、颅脑和四肢等多处伤;手术治疗为本组病例的主要治疗手段。结论:下颌骨骨折中青年男性多见,交通事故伤是其最主要原因,坚固内固定可促进下颌骨骨折的愈合。     

微创切口在下颌骨骨折整形修复中的应用研究

目的:探究微创切口手术治疗下颌骨骨折的美容效果、安全性及患者满意率.方法:回顾性分析笔者医院2015年1月-2019年5月收治的125例下颌骨骨折患者临床资料,所有患者均采取手术治疗,其中62例采取口外颌周切口入路颌间结扎手术治疗,将其作为对照组,63例患者采取微小切口进路坚固内固定手术治疗,将其作为观察组,比较两组患...     

整形美容理念在治疗下颌骨骨折中的临床应用

目的回顾性分析应用整形美容理念治疗下颌骨骨折的临床效果。方法对下颌骨骨折患者采用钛板坚固内固定,复位技术及钛板的固定位置均参考Champy理论;术后根据情况,配合咬殆调整。结果本组共52例患者,术后1例出现局部感染,经清创后愈合,其余51例伤口均Ⅰ期愈合;经6—24个月临床随访,52例患者均恢复到术前的面形及咬胎关系,未出现局部咬殆关系不良,伤口均无明显瘢痕增生。结论采用钛板坚固内固定下颌骨骨折,并在治疗的整个过程中渗入整形美容的理念,效果可靠,患者满意度高。     

感染下颌骨骨折的微型钛板内固定治疗

目的:探讨微型钛板内固定技术在感染下颌骨骨折治疗中的应用价值,并对感染骨折的愈合能力及影响因素作了探讨。方法:选择住院病人37例,术前诊断为下颌骨骨折并感染,均行微型钛板内固定术,同时应用抗生素治疗。结果:37例42处骨折均达骨愈合。其中9例发生术后感染,配合其它治疗发生延迟愈合。结论:感染下颌骨骨折应用微型钛板行坚固内固定是可行的。     

口内入路坚强内固定治疗下颌骨体部骨折

目的：探讨下颌骨骨折手术治疗的径路及其优缺点。方法：口内切口采用小钛板坚固内固定技术治疗16例下颌骨骨折。术后1周、3个月、6个月,根据患者开口度,咬合关系,x线示骨折对位,对线情况,评估其愈合情况。结果：16例患者伤口全部I期愈合。15例咬合关系恢复到伤前咬合关系,1例出现局部咬合关系不良。术后张口度≥37mm,X线示骨折线对位良好。结论：口内入路坚固内固定治疗下颌骨骨折疗效确切,避免了面部皮肤瘢痕和面神经损伤,是治疗下颌骨骨折的有效方法。     

小型钛板坚强内固定术结合颌间牵引治疗下颌骨粉碎性骨折的研究

目的：小型钛板结合颌间牵引在治疗下颌骨粉碎性骨折中与单纯小型钛板坚强内固定术的效果比较分析。方法：下颌骨粉碎性骨折的80例患者中40例采用小型钛板坚强内固定术,40例患者采用小型钛板坚强内固定术配合颌间牵引。结果：40例小型钛板坚强内固定术结合颌间牵引在缩短手术时间,降低手术难度,骨折固位稳定性,咬合关系恢复,减少个别牙早接触等方面具有明显的改善。结论：小型钛板坚强内固定术配合颌间牵引效果优于单纯小型钛板坚强内固定术,疗效满意。     

Operative time analysis of miniplate fixation of the mandible

Our purpose in this study was to report and compare operating room times for the various methods of mandible fracture repair. We describe a methodology of treatment in selected patients, using efficient repair techniques; namely, miniplate fixation with four-screw mandibular occlusion. We report our outcomes in successful healing, occlusion, complications, and operating times. A retrospective chart review was performed of 68 patients suffering mandible fractures treated by various surgeons at a single institution. Miniplate fixation technique requires significantly less time in the operating room than other mandible repair techniques, including mandibulomaxillary fixation. Miniplate fixation technique is both an efficacious and an efficient means of repairing certain mandible fractures.     

微型钢板内固定治疗掌指骨骨折

目的 探讨微型钢板内固定治疗掌指骨骨折的疗效。方法 对14例26处掌指骨骨折，采用国产微型钢板进行内固定治疗。结果 术后随访2～12个月，骨折全部愈合。按TAM评价，功能优8例，良4例。结论 微型钢板内固定操作简单，固定可靠，辅以术后早期功能锻炼，可得到满意的治疗效果，是治疗掌指骨骨折较理想的固定方法。     

AO微型钢板治疗掌指骨骨折

目的研究并分析应用AO微型钢板固定治疗掌指骨骨折的技术及疗效。方法26例36处掌指骨骨折采用切开复位、AO微型钢板螺钉内固定治疗,早期进行功能练习。结果术后随访6月～1年后未出现内固定松动、断裂,X线片示骨折均愈合,伤指指间关节及掌指关节伸屈功能恢复接近正常,按TAM评分,优良率84.6%。结论掌指骨骨折用AO微型钢板螺钉内固定,可获得满意疗效。     

两种手术方法治疗Bennett骨折

目的：评价闭合复位经皮克氏针固定与微型钢板固定治疗Bennett骨折的临床疗效。方法2010年2月-2013年5月,对36例Bennett骨折患者采取闭合复位经皮克氏针固定和微型钢板内固定手术治疗,术后参照拇指腕掌关节功能评定标准进行疗效评定。结果本组优13例,良20例,可3例,优良率为91.7%,疗效满意。结论闭合复位经皮克氏针固定与微型钢板固定治疗临床效果均好,可有效降低术后关节疼痛、活动受限和创伤性关节炎的发生,是治疗Bennett骨折的有效方法。     

Transverse displacement of the proximal segment after bilateral sagittal osteotomy: a comparison of lag screw fixation versus miniplates with monocortical screw technique.

PURPOSE: The purpose of the present study was to compare lag screw fixation versus miniplates with monocortical screw technique with respect to the amount of transverse displacement of the proximal segment after bilateral sagittal osteotomy (BSO) for mandibular advancement surgery. PATIENTS AND METHODS: We conducted a multicenter, retrospective investigation of 82 patients who underwent a mandibular advancement with BSO and rigid internal fixation. Forty-five patients from Denmark and Sweden, the miniplate fixation group, received a rigid fixation consisting of miniplates with monocortical screws. Thirty-seven patients from the Mayo Clinic, the lag screw fixation group, received a rigid fixation with lag screw fixation of the mandible. The transverse displacement and angulation of the proximal segments were measured on posterior-anterior cephalometric radiographs, using the best-fit method. RESULTS: After BSO, 44 of 45 patients in the miniplate fixation group showed an increased transverse intergonion distance with a mean of 5.0 mm and an increase transverse interramus width with a mean of 2.4 mm. Thirty-six of 37 patients in the lag screw fixation group had an increased intergonial width with a mean of 5.6 mm, and 35 of 37 patients showed an increased transverse interramus width with a mean of 3.3 mm. t tests showed that there were no significant differences between the 2 groups with respect to these 2 variables. CONCLUSIONS: Our results indicate that transverse displacements of the proximal segments occur after BSO surgery with both miniplate or lag screw fixation technique. Attention and future studies should focus on possible complications that transverse displacement of the proximal segment may cause.     

Rigid internal fixation with miniplates and screws: a cost-effective technique for treating mandible fractures?

Traditional methods of fixation for stabilization of mandible fractures primarily center around intermaxillary fixation with or without open reduction. During the past decade, rigid internal fixation with miniplates and screws has attained widespread acceptance in the management of acute traumatic injuries to the mandible. With continuing emphasis on cost containment in health care delivery, plastic surgeons will be expected to justify their therapeutic methods as beneficial as well as cost-effective. This is particularly important when a number of acceptable procedures are readily available. The purpose of our investigation was retrospectively to compare treatment with intermaxillary fixation alone, interosseous wire osteosynthesis, and rigid internal fixation with miniplates and screws. We analyzed the hospital records of three such treatment groups, each consisting of 25 patients. Despite initial purchase costs, increased operating time, and the need to develop the skills required to apply the hardware, our study clearly demonstrated that miniplates and screws remain a cost-effective approach to caring for fractures of the mandible. Associated advantages include a quicker return to a preinjury life-style, decreased weight loss, improved oral hygiene and wound care, and protection of the airway, thereby eliminating monitored intensive care unit admissions.