可吸收接骨板在下颌骨骨折内固定治疗中的临床评价

目的:同期观察分析生物可吸收接骨板(BAP)和钛板(TP)在下颌骨骨折内固定治疗中的临床应用效果。方法:2007年─2012年6年内,同期收治下颌骨骨折患者共286例。其中BAP治疗组127例,占总病例数44.4%,以六孔板10 mm螺钉为主,占该组73.35%,人均3.1块。TP组159例,占总病例数55.6%,人均2.3块。两组的部分病例术后辅以颌间弹力牵引。结果:术后创口近期均呈一期愈合,无明显不良反应;咬合关系恢复良好,张口无受限;X线表现从术后4～8周的动态观察表现为渐进性修复重建样影像。4周以后的中期观察在BAP和TP分组分别有4和6例出现类似排异状改变,经换药后治愈。结论:BAP和TP内固定后,排异反应、机械强度及固位作用是相同的,但BAP避免了TP组的二次手术和应力遮挡的弊端。对于机械强度较TP弱的缺点,BAP可通过双板以上的固定、紧密贴合的塑形能力、其本身具有的较强延伸弹性和机械强度等得到解决,并为此提高和延伸了其临床适应证。

Biological Absorbable Bone Plate Internal Fixation in Mandible Fracture

Objective： To observe and compare the effects of biological absorbable bone （ BAP ）plates and titanium （ TP ） plates used in internal fixation in mandible fractures. Methods： From 2007-2012, 286 patients were treated. BAP group comprised of 127 cases, accounting for 44.4%. Six-hole plate with 10ram screws were used in internal fixation in 73.35% cases, 3.1 plates per capita in average. TP group consisted of 159 cases, accounting for 55.6%, 2.3 plates per capita in average. Except internal plates fixation, intermaxillary elastic traction were accompanied in some cases in two groups. Results： All incisions healed with first intention.No obvious adverse reactions occurred. Occlusion relations recovered to normal. No limitation of mouth opening. X-ray examination showed progressive remodeling in the fracture sites. Tissue rejection changes appeared in 4 eases in BAP group and 6 eases in TP group, all were cured after wound dressing. Conclusion： No significant differences were observed between BAP and TP on tissue rejection, mechanical strength, and durability of fixation.