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目的评价单钛板张力带内固定辅以颌间固定治疗下颌角骨折的疗效。方法选择2004年2月至2009年5月在安徽省六安市第二人民医院口腔科治疗的下颌角骨折患者63例,随机分为A、B两组。其中A组35例,采用单钛板张力带内固定辅以颌间固定的方法进行治疗;B组28例,仅单纯采用单钛板张力带内固定的方法进行治疗。两组患者术后随访半年,对术后感染、咬合关系紊乱和张口受限等方面的发生情况进行比较。结果 A组患者术后2例发生感染,1例发生咬合关系紊乱,5例发生张口受限;B组患者术后2例发生感染,5例发生咬合关系紊乱,3例发生张口受限。两组患者在术后感染及张口受限的发生方面比较,差异无统计学意义(P>0.05);而在术后咬合关系紊乱的发生方面比较,差异有统计学意义(P<0.05)。结论采用单钛板张力带内固定辅以颌间固定治疗下颌角骨折,可以克服各自单一使用的缺点,有利于术后骨折愈合及恢复正常咬合关系。
Objective To evaluate the effect of single titanium plate tension band fixation combined with intermaxillary fixation for the treatment of mandibular angle fractures. Methods From February 2004 to May 2009, 63 patients with mandibular angle fractures treated in Department of Stomatology, Second People’s Hospital of Lu’an, Anhui Province were randomly divided into A and B groups. A group of 35 cases, the use of single titanium plate tension fixation combined with intermaxillary fixation method for treatment; B group of 28 cases, only a single titanium plate tension band fixation method for treatment. Two groups of patients were followed up for six months, postoperative infection, occlusal disorders and mouth restriction were compared. Results In group A, 2 patients were infected with postoperative infection. One patient had disorganized occlusal relationship and 5 patients had limited mouth opening. In group B, 2 patients developed postoperative infection, 5 patients had disorganized occlusal relationship and 3 patients had limited mouth opening. There was no significant difference between the two groups in the incidence of postoperative infection and limited mouth opening (P> 0.05), but there was significant difference in the occurrence of occlusal disorders (P <0.05). Conclusion Single titanium plate tension band internal fixation combined with intermaxillary fixation for the treatment of mandibular angle fractures can overcome their shortcomings of single use, which is in favor of postoperative fracture healing and restoration of normal occlusion.