32例复杂性颌骨骨折错位愈合的治疗分析

目的：应用保守治疗、切开复位固定、正颌外科治疗32例复杂颌骨骨折错位愈合患者，探讨各种治疗方法的适应证，并评价其临床效果。方法：保守治疗以牙弓夹板颌问固定为主，切开复位系按手术常规，切开、复位、钢丝或钛板固定，正颌外科系按正颌外科常用术式手术，术后颌问结扎2～3周。结果：伤口均一期愈合，无并发症，咬合关系及外观满意或基本满意。结论：根据颌骨骨折错位愈合的部位、时间、程度、患者年龄等因素综合考虑，选择治疗手段，可最大限度地恢复患者的咀嚼功能及外形。

Treatment of delayed complex malhealed jaw fractures in 32 patients

PUROOSE: Three methods were used to manage delayed complex malhealed jaw fractures in 32 patients. The indication for each method and final result was evaluated. METHODS: Three methods included conservative therapy, internal fixation and orthognathic surgery. In conservative therapy, intermaxillary fixation was obtained with dental arch splints. In internal fixation, ordinary operation was performed including open exposure of the fractured segments, anatomical reposition and rigid fixation with steel wire or titanium miniplates. In some patients, orthognathic surgery was carried out with intermaxillary ligation for 2 to 3 weeks postoperatively. RESULTS: All the wounds healed primarily without significant complications. The postoperative occlusion and appearance were satisfactory or fair. CONCLUSIONS: The selection of treatment methods should be based on the location, time, severity of the fracture and the patients' age, in order to achieve maximal recovery of mastication and appearance.