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目的评价正颌-正畸联合技术治疗颌面骨折二期修复的临床效果。方法对2005年7月至2009年7月43例颌面部骨折二次住院患者,单纯上颌骨骨折4例,单纯下颌骨骨折13例,上下颌骨联合骨折9例,其他联合骨折17例。采用X线投影测量VTO、模型外科及定位牙合板等正颌外科技术进行治疗。观察术前、术后患者面部畸形及功能障碍的变化,探讨正颌外科技术在颌面骨折二期修复的应用要点。结果全组43例均未发生创口感染、骨愈合延迟或愈合不良及钛板排异等不良反应。38例患者术后恢复了理想的面型和咬合关系,3例术后配合正畸牵引也取得了良好的治疗效果,2例患者术后面型及咬合略欠佳。所有患者无严重手术并发症。结论正颌外科技术是治疗颌面骨折二期修复的有效方法,可取得良好的治疗效果。
Objective To evaluate the clinical effect of combined orthognathic-orthodontic technique in the second-stage repair of maxillofacial fractures. Methods From July 2005 to July 2009, 43 patients with maxillofacial fractures underwent two inpatients. There were 4 cases of simple maxillary fracture, 13 cases of simple mandibular fracture, 9 cases of maxillary and mandibular fracture, and 17 cases of other combined fractures. X-ray projection measurement VTO, model surgery and positioning of plywood and other orthognathic surgery for treatment. To observe the changes of facial deformity and dysfunction in preoperative and postoperative patients and to discuss the application of orthognathic surgery in the second phase of maxillofacial fractures. Results All the 43 cases had no wound infection, delayed healing or poor healing and titanium plate rejection and other adverse reactions. Thirty-eight patients recovered the ideal facial and occlusal relationship after operation. Three patients also achieved good therapeutic effect with orthodontic traction, and two patients had slightly better facial appearance and occlusion. All patients had no serious surgical complications. Conclusion Orthognathic surgery is an effective method for the second-stage repair of maxillofacial fractures, and can achieve good therapeutic effect.