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应用穿颊器口内入路微创治疗下颌骨角和升支骨折

Treatment of mandibular angle and ramus fractures by an intraoral and transoral approach

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【作者】 王彦亮刘彦普何黎升王大章薄斌陆斌郑安周树夏

【Author】 Wang Yanliang,Liu Yanpu,He Lisheng,et al.Department of Oral and Maxillofacial Surgery,College of Stomatology,The Fourth Military Medical University,Xi’an 710032,China

【机构】 第四军医大学口腔医学院颌面外科四川大学华西口腔医学院颌面外科美国Synthes公司(中国分公司)颌面外科产品部西安第四军医大学口腔医学院颌面外科 710032西安现在成都四川大学华西口腔医学院颌面外科71003西安成都

【摘要】 目的:观察口内和穿颊的手术入路处理下颌骨角部和升支骨折,并用小钛板坚强内固定的疗效。方法:对2004-01~2005-07间18例连续的下颌骨角部和升支骨折患者,用穿颊器经过颊部小切口联合口内切口复位内固定。随机选取同时期的另外20例同类型骨折患者,仍按照传统口外入路行手术切开复位内固定,2组间进行对比。结果:用口内和穿颊入路患者中有1例内固定术后骨折处仍有小幅动度,还需辅以颌间固定;口外入路行内固定手术的患者中有2例需行术后颌间固定。没有术后感染发生,没有出现需要行切开引流或需取出固定物的病例。结论:通过口内和穿颊入路行坚强内固定适用于不伴有严重错位或粉碎性骨折的下颌骨角部和升支部骨折的病例。

【Abstract】 Objective:To evaluate the treatment with screwed miniplates through an intraoral and transoral approach for patients with angle and ramus fractures. Methods:18 cases of mandibular angle and ramus fractures were treated by screwed miniplates placed through a transbuccal incision with transbuccal trocar instrumentation from January 2004 to July 2005. 20 cases treated through extraoral approach were served as the controls.An intraoral and transoral approach for open reduction and internal fixation of mandible with limited incisions was used to reduce the risk of facial nerve damage and extensive visible scars.Patients were followed-up for 3 months.Results:3 months after operation only one patient treated by intraoral approach and two by extraoral approach required a period of maxillomandibular fixation because of fracture fragments mobile. No postoperative infection occurred in all the cases. Conclusion:The use of rigid internal fixation through an intraoral and transoral approach can be applied in the patients with angle and ramus fractures without severely dislocated fracture fragment.

【基金】 中国博士后科学基金资助(编号:200403501)
  • 【文献出处】 实用口腔医学杂志 ,Journal of Practical Stomatology , 编辑部邮箱 ,2006年05期
  • 【分类号】R782.4
  • 【被引频次】21
  • 【下载频次】158
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