期刊导航

论文摘要

下颌髁突矢状骨折髓内髓外双重内固定术的临床应用

Extramedullary fixation combined with intramedullary fixation in the surgical reduction of sagittal mandibular condylar fractures

作者:陈传俊 陈晓阳 陈静

Author:Chen Chuanjun, Chen Xiaoyang, Chen Jing.

收稿日期:2016-05-23          年卷(期)页码:2016,34(5):474-474-477

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:髁突矢状骨折,坚强内固定,髓内固定,髓外固定,

Key words:sagittal condylar fracture,rigid internal fixation,intramedullary fixation,extramedullary fixation,

基金项目:

国家自然科学基金(815500037)

中文摘要

目的 探讨髓内及髓外双重内固定在下颌髁突矢状骨折开放复位内固定中的应用价值。方法 采用髓内髓外双重内固定术治疗18例24侧髁突矢状骨折,固定方法:单一螺钉或克氏针行髓内固定,配合一块钛板行髓外固定,伴发他处骨折者同期行精确复位固定。术后通过拍摄CT和全景X线片评价钛板固定情况、骨折段复位精准度及稳固性,通过临床检查评价咬合关系、开口度、开口型。结果 术后X线全景片或CT检查显示,24侧髁突矢状骨折段均未发现术后旋转移位,对位良好;钛板和螺钉无扭曲、折断和松脱。术后咬合关系、开口度、开口型恢复良好。结论 髓内髓外双重内固定具有抗骨折段旋转作用,髓内螺钉和髓外钛板在空间上互不干扰,是下颌骨髁突矢状骨折固定的良好方法。

英文摘要

Objective This study aimed to evaluate the clinical effect of extramedullary fixation combined with intramedullary fixation during the surgical reduction of sagittal mandibular condylar fractures.Methods Twenty-four sagittal fractures of the mandibular condyle in18 patients were fixed by two appliances: intramedullary with one long-screw osteosynthesis or Kirschner wire and extramedullary with one micro-plate. The radiologically-recorded post-operative stability-associated complications included the screw/micro-plate loosening, micro-plate twisting, micro-plate fractures, and fragment rotation. The occluding relations, the maximalinter-incisal distances upon mouth opening, and the mandibular deflection upon mouth opening were evaluated based on follow-up clinical examination.Results Postoperative panoramic X-ray and CT scans showed good repositioning of the fragment, with no redislocation or rotation, no screw/plate loosening, and no plate-twisting or fracture. Clinical examination showed that all patients regained normal mandibular movements, ideal occlusion, and normal maximal inter-incisal distances upon mouth opening.Conclusion Extramedullary fixation combined with intramedullary fixation is highly recommended for sagittal condylar fractures because of the anti-rotation effect of the fragment and the reasonable placement of the fixation appliances.

下一条:桡侧蒂旋转推进筋膜皮瓣修复前臂皮瓣供区缺损

关闭

Copyright © 2020四川大学期刊社 版权所有.

地址:成都市一环路南一段24号

邮编:610065