刚性内固定与三维微型钢板内固定治疗下颌骨同时角骨折和对侧体/干骺端骨折的临床效果(包括神经感觉缺损和疼痛评分)比较评估:前瞻性随机对照研究》。

Asian journal of neurosurgery Pub Date : 2024-06-24 eCollection Date: 2024-09-01 DOI:10.1055/s-0044-1787864
Satish Kumar, Ajay Chandran, Syed Sirajul Hassan, Davide Rocchetta, Abdulsalam S Alshammari, Faris Jaser Almutairi, Suresh Babu Jandrajupalli, Swarnalatha Chandolu, Abhishek Singh Nayyar
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引用次数: 0

摘要

目的 当前,治疗下颌骨骨折的策略取得了许多进步,尽管存在许多缺点,但切开复位内固定仍被认为是治疗此类骨折的首选方法。本前瞻性随机对照研究旨在评估采用三维(3D)微型钢板内固定术进行刚性内固定治疗的下颌骨骨折的临床效果,包括神经感觉缺损和疼痛评分变量。材料和方法 在本研究中,共纳入了 20 名年龄在 18 至 55 岁之间、同时患有下颌骨角骨折和对侧骨体/干骺端骨折的男女患者,并对两组患者的临床结果进行了比较,其中一组采用了刚性内固定,另一组采用了三维小板内固定等不同的治疗方案。结果 通过 Mann-Whitney U 检验对第一组和第二组患者在不同时间段的疼痛评分进行配对比较,结果显示,除第二组患者术后 1 个月和 3 个月的结果比较外,所有配对结果均具有统计学意义。此外,从术前到术后 1 个月再到术后 3 个月的评估结果显示,第 I 组和第 II 组患者在愈合过程中都出现了明显的恢复,而在不同时区观察到的神经感觉缺损方面的变化,第 I 组和第 II 组患者的结果均具有高度统计学意义(P = 0.0001)。结论 根据所获得的结果,可以得出结论:在研究中发现,在固定下颌骨不利的骨体/骨干旁骨折时,三维微型板引导的骨合成与使用重建板完成的骨合成具有可比性,在提供最佳稳定性的同时,还能令人满意地满足咬合负荷的生物力学要求,并能尽早恢复正常功能。
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Comparative Evaluation of Clinical Outcome Including Neurosensory Deficit and Pain Score Variables Using Rigid Internal Fixation with Three-Dimensional Miniplate Internal Fixation in Simultaneous Angle and Contralateral Body/Parasymphysis Fractures of the Mandible: A Prospective, Randomized Controlled Study.

Purpose  There have been numerous advancements in the strategies used for treating mandibular fractures in the present times, while open reduction and internal fixation is still accepted as the most preferred treatment option for such fractures despite numerous drawbacks. The aim of the present prospective, randomized controlled study was to evaluate the clinical outcome including neurosensory deficit and pain score variables in mandibular fractures that were treated using rigid internal fixation with three-dimensional (3D) miniplate internal fixation. Materials and Methods  For the present study, a total of 20 patients of either sex in an age range of 18 to 55 years with simultaneous angle and contralateral body/parasymphysis fractures of the mandible were included, while the clinical outcome was compared in relation to the two groups wherein different treatment options were used including using rigid internal fixation in one as against 3D miniplate internal fixation in the other. Results  Pairwise comparison of pain scores in Group I and Group II patients by the Mann-Whitney U-test at different time zones revealed the results to be statistically significant for all pairs except when the findings were compared between 1 month and 3 months after the procedure in Group II patients. Also, significant recovery was observed in both Group I and II patients during healing when assessed preoperatively to 1 month and then 3 months after the procedure with the results being statistically highly significant in case of the variations observed in relation to the neurosensory deficit observed at different time zones for both Group I and II patients ( p  = 0.0001). Conclusion  Based on the results obtained, it can be concluded that 3D miniplate-led osteosynthesis was found comparable to the osteosynthesis accomplished using reconstruction plates during fixation of unfavorable body/parasymphysis fractures of mandible in study, providing optimal stability, while satisfactorily meeting the biomechanical requirements for occlusal loading, and an early return to normal function.

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