内窥镜辅助复位内固定治疗下颌角骨折临床研究.docVIP

内窥镜辅助复位内固定治疗下颌角骨折临床研究 　　【摘要】 目的 探讨内窥镜技术在手术切开复位内固定治疗下颌角骨折中的应用。方法 34例(37侧)下颌角骨折患者中,22侧单线不利型骨折,13侧复杂性骨折,2侧粉碎性骨折。术中经口内入路,在内窥镜监视下复位移位的骨折段,并在外斜线上方和采用穿刺套管或侧壁电钻在下颌下缘处固定一个小型钛板。结果 34例(37侧)下颌角骨折,在内窥镜辅助下完成手术复位和内固定。术后除粉碎性骨折外,所有患者均实现解剖复位。术后复查与随访骨折复位固定良好、无并发症。结论 经口内入路内窥镜辅助手术复位和小型钛板两板固定临床可用于沿外斜线单板固定稳定性不足的下颌角骨折,如不利型的单线骨折、复杂性骨折、具有严重移位的骨折等;该手术方式具有微创和美观等优点。 　　【关键词】 下颌角;骨折;坚固内固定;内窥镜 　　 　　Clinical research of endoscopy-assisted open reduction and internal fixation for the management of mandibular angle fractures 　　 　　WANG Yu-liang,JIANG Hai-ming,ZHANG Xiao-ming,et al.Department of Oral and Maxillofacial Surgery,Affiliated Hospital of Binzhou Medical College,Binzhou 256603,China 　　【Abstract】 Objective Management of mandibular angle fractures was often challenging.The report was to describe the application of endoscopy in the open reduction and rigid fixation by the transoral approach for the management of mandibular angle fracture when the Champy technique was not indicated.Methods A series of 34 patients with 37 sides of serious mandibular angle fractures was admitted for endoscopy-assisted surgery,of which 22 sides were unfavorable fractures with one fissure,13 sides were complicated fractures,and 2 side was comminuted fracture.Monocortical fixation by the transoral approach was performed with one minipalte at the superior border of the mandible medial to the external oblique line and one miniplate at the inferior border with the aid of a percutaneous trocar.Results Adequate anatomic reduction and pretraumatic occlusion were achieved under the supervision of endoscope with intermaxillary fixation except one patient who achieved functional reduction.The physical examination and radiological imaging demonstrated no infection,nerve deficiency,malocculsion or other complications.Conclusion The endoscopy-assisted open reduction and two rigid fixation with miniplates by the transoral approach prove to be a reliable surgical method for the management of unfavorable,severely dislocated,