75例下颌骨粉碎性骨折的治疗效果评价

doi:10.19438/j.cjoms.2021.05.013

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (5): 456-459.doi: 10.19438/j.cjoms.2021.05.013

75例下颌骨粉碎性骨折的治疗效果评价

徐晓峰^1,*, 朱方兴^2,*, 廖倩¹, 徐兵¹, 沈国芳¹, 张文斌^1#, 史俊^1#

1.上海交通大学医学院附属第九人民医院口腔颅颌面科,上海交通大学口腔医学院, 国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011;
2.上海交通大学医学院附属第六人民医院口腔科,上海 200233

收稿日期:2021-02-25 修回日期:2021-05-06 出版日期:2021-09-20 发布日期:2021-10-20
通讯作者: 史俊,E-mail:563109046@qq.com;张文斌,E-mail:zwb96493@hotmail.com。^#共同通信作者
作者简介:徐晓峰(1989-),男,硕士,主治医师,E-mail:xuxiaofeng110@163.com;朱方兴(1994-),男,硕士,住院医师,E-mail:Sp_terry94@163.com。*并列第一作者
基金资助:
上海市科技委员会国际合作项目(17410710500,19441906000); 上海交通大学机器人研究院第九人民医院临床研究中心项目(IMR-NPH202003); 上海交通大学医学院附属第九人民医院临床研究型MDT项目（201906）; 上海交通大学医学院附属第九人民医临床研究助推计划（JYLJ201920）

Evaluation of treatment results of 75 patients with comminuted mandibular fractures

XU Xiao-feng¹, ZHU Fang-xing², LIAO Qian¹, XU Bing¹, SHEN Guo-fang¹, ZHANG Wen-bin¹, SHI Jun¹

1. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Disease; Shanghai Key Laboratory of Stomatology. Shanghai 200011;
2. Department of Stomatology, Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200233, China

Received:2021-02-25 Revised:2021-05-06 Online:2021-09-20 Published:2021-10-20

摘要/Abstract

摘要： 目的提出一种针对下颌骨粉碎性骨折的分类方法,并尝试将其用于临床评价。方法回顾75例下颌骨粉碎性骨折患者,按照下颌骨是否伴有节段性骨缺损、下颌骨形态、下颌骨的粉碎程度、可否恢复稳定的咬合关系对其进行分类。按照严重程度,进行保守治疗或使用小型钛板、钛网或重建板进行手术。其中,44例按照分类及治疗策略进行治疗（实验组）,另外31例未按照分类进行治疗（对照组）。结果高空坠落和车祸是下颌骨粉碎性骨折最主要的原因。实验组中3例患者术后出现感染,1例出现咬合紊乱;对照组中4例患者出现感染,2例出现骨不连,2例出现咬合紊乱,1例出现颌骨不对称畸形。结论本研究尝试创建一种全新的以治疗为导向的下颌骨粉碎性骨折分类方法及治疗策略,对在该类骨折治疗过程中治疗手段的选择具有一定的指导作用,其价值仍需进一步研究。

关键词: 下颌骨, 粉碎性骨折, 分类, 重建板, 钛网

Abstract: PURPOSE: This study aimed at proposing a new treatment-oriented classification and treatment algorithm of comminuted mandibular fractures based on analysis of 75 consecutive cases. METHODS: Seventy-five patients with comminuted mandibular fractures were retrospectively reviewed in this study. The classification was based on whether a stable occlusal relationship could be regained, morphology of mandible after trauma, degree of comminution and whether segmental mandibular bone defect happened. Based on traumatic condition, five classes were categorized and conservative treatment, miniplates fixation, reconstruction plates fixation, staged operations fixation with titanium meshes and bone flap transplantation were used for the management of the fracture. Forty-four patients in the experimental group were treated according to the classification while other thirty-one in the control group were not. RESULTS: After surgery, three patients developed infection, one patient presented malocclusion in the experimental group. Four patients developed infection, two patients had bone un-union, two patients presented malocclusion and one patient had mandibular asymmetry in the control group. CONCLUSIONS: The treatment-oriented classification and algorithm for comminuted mandibular fractures provide guidance for the choice of treatment methods and can decrease complication rate but further clinical research is needed.

Key words: Mandible, Comminuted fracture, Classification, Reconstruction plate, Titanium mesh

中图分类号:

R782

徐晓峰, 朱方兴, 廖倩, 徐兵, 沈国芳, 张文斌, 史俊. 75例下颌骨粉碎性骨折的治疗效果评价[J]. 中国口腔颌面外科杂志, 2021, 19(5): 456-459.

XU Xiao-feng, ZHU Fang-xing, LIAO Qian, XU Bing, SHEN Guo-fang, ZHANG Wen-bin, SHI Jun. Evaluation of treatment results of 75 patients with comminuted mandibular fractures[J]. China J Oral Maxillofac Surg, 2021, 19(5): 456-459.

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75例下颌骨粉碎性骨折的治疗效果评价

Evaluation of treatment results of 75 patients with comminuted mandibular fractures

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