两种不同内固定方法治疗下颌骨骨折的效果分析

目的 :对钢丝结扎内固定及小夹板内固定的治疗效果进行分析 ,以帮助医生确定适宜的内固定方法。方法 :对 86例下颌骨骨折进行上述两种内固定方法治疗。手术方案由主治医师及副主任医师制定。术后追踪随访 6周 ,记录术后咬牙合关系不良及开口时颞颌关节疼痛的发生情况 ,将术后合并症发生率与内固定方法、术者经验及骨折情况等因素一起进行统计学分析。结果 :两组不同内固定方法的治疗效果无显著性差异 ,但在双处骨折中 ,小夹板内固定的术后合并症发生率明显高于钢丝内固定组。两组医生完成的手术治疗效果无显著性差异 ,但主治医师完成的小夹板内固定术后合并症发生率明显高于副主任医师组。片层状断面或合并有片层状断面的骨折术后合并症发生率较高。结论 :影响下颌骨骨折治疗效果的因素有许多 ,选择适宜的内固定方法是取得良好治疗效果的关键。

The analysis of outcomes from the wire fixation and the rigid internal fixation.

Objective: To analyze the treatment results from the wire osteosynthesis and the miniplate fixation and to help doctors make a reasonable internal fixation methods. Methods: Eighty-six patients with mandibular fractures were treated with wire osteosynthesis and miniplate fixation. The treatment methods were made by the two groups of doctors , namely doctors-in -charge and vice-professors. In the follow-up time of 6 months , disocclusion and temperomandibular joint pain on the opening mouth in the two different treatment groups were documented .Statistical analysis were performed by combining the rate of complications after operation with the fixation methods, the experience of operator and the conditions of fractures. Results : Generally, the results from the two different internal fixation methods were nonsignificant ; but on the occasion of double fractures , the complication rate of the miniplate fixation were significantly higher than the wire fixation . The treatment outcomes from the two groups of doctors were no significant; but the complication rate of miniplate fixation by doctors-in-charge were significantly higher than by vice-professors. The possibility of the complication from the fracture fragments of or with long thin oblique plane were higher. Conclusions:The factors influencing the treatment results of the mandibular fracture were various. The main factors included the numbers of fracture fragments , the surface shape of fracture fragments and the choice of treatment methods. The key of good treatment outcomes was selecting reasonable fixation methods. [