【摘要】 目的　探讨牵引成骨术在功能性颌骨重建中的应用。方法　使用 3种不同类型的国产颌骨牵引器 (2种是为颌骨不同类型重建而专门设计 )及德国Martin公司生产的垂直牵引器 ,共完成 6例不同类型的颌骨缺失重建 ,其中 2例升支大部切除 ,1例下颌骨体左侧缺失 ,3例分别为右侧及颏部保留下颌骨下缘的方块切除术后及下颌骨体左侧切除术后髂骨移植而骨量不足者。结果　 5例按术前设计的要求顺利完成牵引成骨重建 ,1例因牵引器一侧固定臂螺钉从移动骨块上穿透仅完成一半缺失区 (2 3mm)的牵引成骨。全部病例均无感染、成骨不良等并发症。结论　牵引成骨技术可成功应用于功能性颌骨重建 ,较常规重建方法具有独特优势。不同类型的颌骨缺失重建皆可使用牵引成骨技术 ,最佳的牵引成骨时机是与肿瘤切除术同期进行更多还原

【Abstract】 Objective To study the application of distraction osteogenesis in mandibular functional reconstruction. Methods Three kinds of mandibular distractors were used in 6 cases who had different mandibular defects because of tumor resection. For two cases with defect of most part of ramus specially desinged distractors were used in order to keep the normal height of the ramus. In one case the trifoci distraction principles were used and a trifoci distractor was desinged. In three cases the vertical distractors made in Germany or China respectively were used. The average age of 6 patients was 31.5 years old (from 8 to 54). Results The mandibular lengthenings in 5 cases were fully successful according to the direction and distance desinged before distraction. In one case the trifoci distraction principle was applied and a proximal 23 mm mandibular defect was corrected succesfully, however, the 23 mm distal mandibular defect had not corrected because the screws for fixation of the transport block was loosened. No infection and dysosteogenesis were happened in all cases. Conclusions Distraction osteogenesis can successfully be used in mandibular functional reconstruction and has much more adventages than traditional techniques. The most favorable time for distraction osteogenesis in mandibular reconstruction is at the same stage of tumor resection.更多还原