[下颌骨折手术与保守治疗的疗效及并发症]。

E Reinhart, J Reuther, C Michel, N Kübler, H Pistner, J Bill, E Kunkel
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引用次数: 0

摘要

回顾性分析712例1166例下颌骨骨折患者,并对374例593例骨折患者进行随访研究,以区分手术与保守骨折治疗在伤口愈合、骨愈合及后期效果上的差异。46.1%(328例)采用保守治疗,53.9%(384例)采用手术治疗。术后随访255例,保守治疗119例。3.0%的手术患者发生细菌感染,而保守治疗的患者发生细菌感染的比例为8.7%。从骨折区的咬合、关节、下颌运动等功能方面以及影像学表现来看,手术治疗后患者的随访结果较保守治疗组有部分显著性改善。下肺泡神经和精神神经的神经学检查显示,保守治疗组的结果明显较好。由于手术治疗后功能效果较好,在无禁忌症的情况下应采用微型钢板进行骨固定。更精确的重建和稳定碎片缩短住院时间,使下颌骨功能更快恢复。
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[Treatment outcome and complications of surgical and conservative management of mandibular fractures].

Retrospective analysis of 712 patients with 1166 mandibular fractures and follow up-study of 374 patients with 593 fractures was performed for discrimination of differences in wound- and bone-healing as well as late results between operative and conservative fracture treatment. 46.1% (328) of all patients have been treated conservatively, 53.9% (384) have been treated by operation. The follow up was performed on 255 patients with operative fracture treatment and 119 patients with conservative treatment. In 3.0% of the operatively treated patients bacterial infections occurred, in comparison to 8.7% of conservatively treated patients. From the viewpoint of functional aspects, such as occlusion, articulation and mandibular movement as well as radiological signs in the fractured region patients after operative treatment have shown partly significantly better results during the follow up compared to the group of conservatively treated patients. Neurological testings of inferior alveolar nerve and mental nerve have shown significantly better results in the group of conservatively treated patients. Since the functional results are much better after operative treatment, osteosynthesis with miniplates should be performed if there are no contraindications. The more precise reconstruction and stabilization of the fragments shortens time of hospitalization and leads to sooner functionality of the mandible.

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[Transoral miniplate osteosynthesis of mandibular condyle fractures--optimizing the surgical method]. [Results of follow-up of temporomandibular joint fractures in 30 children]. [Neurologic examinations for facial nerve damage in surgically treated mandibular collum fractures]. [Fractures of the mandibular collum in childhood--a long-term follow-up with orthopantomography]. [Mandibular micrognathism as a sequela of early childhood capitulum fractures and their treatment using distraction osteogenesis].
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