简易穿颊器在下颌骨骨折中的临床应用

目的探讨简易穿颊器在下颌骨骨折内固定中的临床意义。方法对36例下颌骨角部、升支骨折患者,采用口内切口,利用骨科打孔导向器改制成的简易穿颊器和骨科用手枪电钻,经颊部皮肤穿刺打孔,小型钛板内固定。结果所有病例面部皮肤均无明显手术疤痕,无面瘫症状。术后3个月～3年复查曲、面断层片或螺旋CT三维重建,骨折线对位良好。31例咬合关系完全恢复,3例下颌骨两处骨折患者术后前牙轻微开(牙合),经颌间弹性牵引一周后好转。2例术后伤口积液血肿,经口内再次皮片引流后愈合。结论利用简易穿颊器辅助,经口内切口内固定下颌骨角部和升支部骨折,可避免颌面部皮肤明显的手术疤痕和面神经损伤的风险,具有一定的临床应用价值。

Clinical application of simple transbuccal trochar in internal fixation of mandibular fracture

Objective To investigate clinical application of simple transbuccal trochar in internal fixation of mandibular fracture.Methods 36cases of mandibular angle and ramus fractures were fixed with simple transbuccal trocar instrumentation through a transbuccal incision reformed by the percutaneous puncture cannula guide device.Results The periods of follow-ups ranged from 3 to 36 months.All patients showed no visible facial scars and facial nerve injury,all fractures were anatomically reduced.Except for slight open bites existing in 3 cases and postoperative hematomaes existing in 2 cases,they recovered after intermaxillary elastic traction and rubber drainage again.Conclusions The intra-oral approach for placement of fixation plates for treatment of mandibular angle and ramus fracture has several advantages including having no visible facial scars and facial nerve injury.It would be a cheap method of choice in treatment of mandibular angle and ramus fractures,especially in grass-roots hospitals.