颏部粉碎性骨折17例临床总结

目的:探讨下颌骨颏部粉碎性骨折的应急处理、诊断和治疗。方法:颏部粉碎性骨折患者急诊时以单颌牙弓夹板结扎固定,防止舌后坠,保持呼吸道通畅,减少下颌骨运动时出血。术前行颌骨螺旋CT三维重建成像检查,然后全麻下行颌骨坚强内固定术,必要时辅以颌间牵引术。结果:17例颏部粉碎性骨折患者均得到了及时有效的治疗,获得了理想的复位和良好的咬合关系,无窒息、下颌弓狭窄等并发症发生。结论:利用下颌牙齿,早期对颏部粉碎性骨折行单颌牙弓夹板结扎固定,是及时有效的手段,螺旋CT三维重建成像是目前诊断和治疗下颌骨粉碎性骨折的最佳辅助检查手段,坚强内固定术辅加颌间牵引术是治疗颏部粉碎性骨折的理想方式。

Treatment of Comminuted Fractures of the Mental Symphysis of Mandible

Objective: To summarize the diagnosis,first-aid treatments,and surgical reductions in the management of comminuted fractures of mental symphisis of the mandible.Methods: 17 cases were retrospectively reviewed.The emergency treatments consisted of fracture fragments fixation with arch bars in order to prevent downward displacement of the tongue,to maintain the respiratory tract unobstructed,and stop bleeding.After spiral CT examination and threedimensional restoration,the rigid internal fixation(RIF),occasionally added auxiliary intermaxillary elastic traction was adopted under general anesthesia.Results: 17 cases achieved satisfactory results with normal occlusion.No complications were seen.Conclusion: 3D spiral CT examination are effective measures in the emergency department.Rigid internal fixation accompanied with auxiliary intermaxillary traction is the ideal choice to cure mandibular chin fractures.