颌间牵引在下颌骨多发性骨折坚强内固定手术中的应用

目的：探讨颌间牵引在下颌骨多发性骨折坚强内固定手术中的作用。方法：对38例下颌骨多发性骨折病例,采用开放复位坚强内固定手术配合术前术中术后颌间牵引治疗,术后1、3、6月摄下颌骨正侧位片、全颌曲面断层片或三维CT复查骨折复位愈合情况并检查咬合关系。结果：38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,36例咬合关系恢复正常,2例合并下颌角部粉碎性骨折病例个别牙咬合有早接触,调后咬合关系恢复正常。结论：下颌骨多发性骨折坚强内固定术前术中使用颌间牵引能有效辅助骨折解剖复位、保持正常咬合关系下行坚强内固定;术后维持短期颌间牵引,对保持骨折复位愈合、咬合关系恢复具有重要作用。

The application of intermaxillary traction in the surgical treatment of rigid internal fixation of mandible multiple fracture

Objective： To discuss the effect and necessity of in the surgical treatment of rigid internal fixation of mandible multiple fracture. Method： Experiences of 38 cases of mandible multiple fractures caused by traffic accidents and falling accidents. Open reduction and rigid internal fixation will be applied for the surgical treatments, combined with the application of intermaxillary traction before, during and after the surgery. In the first, third and sixth month after the surgery, PA ＆ LAT, panoramic X-ray fihn and 3D-CT will be taken respectively concerning the mandible to check the re- duction and healing of fracture and occlusion relationship. Result： It brings sound results of reduction and healing after surgery under healing by first intention for the 38 cases of mandible multiple fractures. The occlusion relationships of 36 cases wherein were well reduced. For the other 2 cases, combined eomminuted fractures were found in the mandible angle and slight premature contacts occurred. After occlusal adjustment,the occlusion relationships were recovered normally. Conclusion： The application of intermaxillary traction before and during the surgical treatments of rigid internal fixation of mandihle multiple fracture will effectively and supplementary reduce fracture and align the occlusion relationship. It will maintain the rigid internal fixation under normal occlusion relationship. The maintenance of intermaxillary traction for a short period after the surgery will play a significant role in the reduction, healing and stability of fracture as well as the re- covery of occlusion relationships. It is a necessary treatment method.