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目的:总结下颌骨粉碎性骨折的手术治疗方法。方法:对45例下颌骨粉碎性骨折采用口内或口外广泛切开,充分暴露骨折区全貌,并进行下颌骨的解剖复位,采用重建板坚强内固定。结果:45例下颌骨粉碎性骨折术后44例伤口一期愈合,骨折复位愈合良好,咬合关系恢复良好,张口度正常;1例术后下颌前庭沟黏膜处钛板小部分外露,经局部治疗,保持口腔卫生、预防感染,8个月后手术取出固定钛板螺钉,骨折处对位愈合良好,咬合关系良好,无骨感染、骨不连发生。结论:广泛切开能凊楚显露下颌骨粉碎性骨折的骨折线全貌,方便在直视下准确复位固定各骨折块、恢复下颌骨的解剖结构,获得良好的咬合关系。重建板固定骨折具有良好的稳定性和可靠性,适用于下颌骨粉碎性骨折。
Objective: To summarize the surgical treatment of mandibular comminuted fracture. Methods: Forty - five patients with comminuted mandibular fractures were extensively excised by mouth or mouth. The whole fracture area was exposed and anatomic reduction of the mandible was performed. RESULTS: Forty-four cases of 45 cases with mandibular comminuted fracture were healed by one-stage wound healing. The fractures healed well, the occlusal relationship recovered well and the mouth opening was normal. One case of titanium plate in the posterior mandibular groove mucosa was partially exposed, , To maintain oral health, prevent infection, 8 months after the operation to remove the fixed titanium screws, fracture healing at the right place, good occlusion, boneless infection, nonunion occurred. CONCLUSION: A wide range of incision can reveal the entire fracture line of comminuted fracture of the mandible. It is convenient to accurately reset and fix each fracture block under direct vision and restore the anatomic structure of the mandible, thus obtaining a good occlusal relationship. Reconstruction plate fixation fracture has good stability and reliability, suitable for mandibular comminuted fracture.