外伤性颌面部骨折的正颌外科治疗

目的：探讨外伤性颌面部骨折患者实施正颌外科治疗的适应症、治疗步骤及容易出现的问题。方法：从1990年7月～1999年4月，我科共收治了67例因外伤性颌面部陈旧性骨折引起错位愈合而实施正颌外科手术的患者，骨折包括面中18骨折，下颌骨骨折，多发性骨折。采用的术式包括LefortI截骨术、下颌骨垂直或矢状劈开截骨术、切开复位固定术等，术中均采用骨间的小钛板坚强内固定。结果：术后63例获得良好的解剖外形及咬合关系。2例颧上颌骨骨折的患者，术后颧骨突度略显不足；2例下颌骨骨折患者术后出现局部感染，经二期手术后愈合。结论：对于外伤性颌面部陈旧性骨折引起的牙、、面畸形，正颌外科手术既能恢复其良好的解剖外形，又能改善其咬合关系，是目前最为行之有效的治疗方法。

The Orthognathic Surgery of Malposed Maxillofacial Fractures

Objective: This article is devoted to discuss the indications for orthognathic surgery for the traumatic fractures inthe maxillofacial area, the procedure and common problems of the surgery. Methods: 67 patients treated by orthognathicsurgery because of the malpositional healing were admitted between 1990 ~ 1999. Types of fractures included midfacefractures, mandibular fractures and multiple fractures. Lefort I osteotomy, Sagittal split ramus osteotomy, open reduction andinternal fixation etc, were used with titantium miniplates. Results: 63 patients showed satis factory anatomical contour andocclusal relationship; 2 patients with zygomaticomaxillary complex fractures (2 fractures) seemed some f1attering of the malarprominencq 2 patients with mandibular fractures infected after operation and healed through the secondary surgery.Conclusion: The intervention of orthognathic surgery is the most useful and effective treatment to reach normal anatomiccontour and to make the occlusal relationship better for the deformations of dentition, occ1usion and face caused by maxillofacialmalposed fractures.