頁籤選單縮合
題 名 | Management of Mandibular Angle Fractures: A Comparison between the Intraoral and the Extraoral Approach=下頷角骨折手術治療:經口內及經臉部切口復位固定方式之比較 |
---|---|
作 者 | 王柏方; 陳建宗; 廖漢聰; 陳志豪; 陳怡傑; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 23:1 2014.03[民103.03] |
頁 次 | 頁1-11 |
分類號 | 416.956 |
關鍵詞 | 下頷角骨折; 經口內切口術; 經臉部切口術; Facial fracture; Mandible angle; Open reduction and internal fixation; Facial nerve palsy; Inferior alveolar nerve injury; |
語 文 | 英文(English) |
中文摘要 | 背景:外傷性下頷角骨折的手術治療以開放性復位及內固定可達到良好的骨折癒合及恢復適當的咬合。不同的手術方式,包括手術切口位置、固定骨板的位置等會影響術後的結果及造成的併發症。目的及目標:本研究的目標是在比較經口內切口及經臉外部切口來治療下頷角骨折兩群病患,包括術後結果、併發症等。材料與方法:我們回溯林口長庚醫院從1999到2007年外傷性下頷骨角骨折,曾接受手術復位及內固定治療的病患。並將病患分成兩組,其一為經口腔黏膜切口(第一組),另一組為經臉外部切口來進行骨折復位(第二組)。比較兩組病患基本資料、開刀方式及時間、並追蹤術後骨頭癒合情形、咬合情形、及相關併發症等。結果:總共122位病患,口內切口組為79位,臉部切口組為43位。術後骨折癒合不良一位(1.1%);術後咬合不良需牙科矯正治療或手術治療的第一組7.5%,第二組4.6%。兩組傷口感染機率相似。超過三個月下唇感覺神經異常的比例第一組18.9%,第二組25.5%;顏面神經下頷分支(marginal mandibular nerve)麻痺的比例為第一組1.1%,第二組11.6%。而經臉外部切口造成疤痕不滿意病患佔18.6%。結論:下頷骨角外傷性骨折無論是經口內切口相對臉部切口皆可達到和臉部切口相同的骨折癒合及牙齒咬合。經口腔內切口術式較需技巧性,但手術造成的顏面神經麻痺比例較低,且無外部傷口疤痕的問題,是目前較常被採用的方式。 |
英文摘要 | Background:Appropriate surgical treatment of mandibular angle fractures yields excellent surgical outcomes. The way of approach used for fracture exposure, reduction and fixation can have an impact on the surgical outcome.Aim and Objectives:This study compared the surgical outcome between intraoral and extraoral approach for the management of mandibular angle fractures.Materials and Methods:This was a retrospective study involving 122 patients with mandibular angle fractures, which was managed by open reduction and internal fixation in Chang Gung Memorial Hospital in Linkou from 1999 to 2007. Comminuted angle fractures were excluded. These patients were divided into two groups. Group I included 79 patients managed through intraoral approach and group II was 43 patients with extraoral approach.Results:Malocclusion requiring surgical or orthodontic correction occurred in 6 (7.5%) patients in Group I and 2 (4.6%) patients in Group II. Postoperative infections occurred in 8 (10.1%) patients in Group I and 5 (11.6%) in Group II. Long-term sensory disturbances of the lower lip were noted in 15 (18.9%) patients in group I and 11 (25.5%) patients in group II. Only one patient (1.1%) suffered from prolonged facial nerve palsy in intraoral approach group and 5 (11.6%) patients in extraoral approach. The average operative times were similar in both groups.Conclusion:The intraoral approach is the preferred approach in the majority of patients with mandibular angle fractures. It is technically more challenging but as effective as the extraoral approach in repair mandibular angle fractures, with less complications of marginal mandibular branch of facial nerve injuries and unsatisfactory facial scars. |
本系統中英文摘要資訊取自各篇刊載內容。