A retrospective comparative study of mandibular fracture treatment with internal fixation using reconstruction plate versus miniplates

PurposeThis study compared the clinical success rates of mandibular fracture treatment using reconstruction plates or miniplates and clarified the selection criteria for reconstruction plates.MethodsAll patients who had surgically-treated mandible fractures from 2008 to 2017 with sufficient follow-up were retrospectively analyzed for information about the fracture condition, treatment, and outcomes.ResultsA total of 126 surgically-treated mandible fractures without mandibular condylar fracture in 105 patients (76 male, 29 female) were included. Reconstruction plates were used in 32 fractures with very good postoperative occlusal function. Four cases with complications requiring reoperation were treated using only miniplates. Variables that were statistically associated with follow-up surgery included simple versus comminuted mandible fracture, and the absence of teeth that could be used for intermaxillary fixation (P < 0.05). In the miniplates treatment for comminuted fracture, there was a significant difference in the treatment outcome depending on the number of free bone-fragments and the presence of bone-fragments requiring removal within 1 cm (P < 0.05).ConclusionReconstruction plates provided better treatment outcomes for comminuted fractures and fractures without teeth. Selecting a reconstruction plate that is capable of sufficiently overloading is important in comminuted fractures with multiple free bone-fragments and bone-fragments requiring removal.     

根管预备的工作宽度

根管预备的工作宽度是指根管应该被扩大的程度。适宜的工作宽度是在尽可能保存牙体组织的前提下,彻底去除根管内的感染源,达到最佳的清理和成形效果。由于根管解剖形态的多样性以及根管内感染的复杂性,对于根管预备的工作宽度尚无明确定论,文章就根管预备的工作宽度做一介绍。     

Fractures of the proximal radius and ulna

Acute injuries of the proximal radius and ulna can be challenging to manage. This review article summarizes the classification, injury patterns, treatment and outcome of fractures of the olecranon, coronoid process, adult Monteggia fracture dislocations and radial head fractures. Undisplaced fractures and stable injuries can be treated conservatively and displaced and complex injuries should be treated surgically to permit early range of motion with a functional rehabilitation programme.