临床误诊误治2017，Vol.30Issue(7)：34-38,5.DOI:10.3969/j.issn.1002-3429.2017.07.011
颌面部骨折治疗失败后二期治疗探讨:附51例报告
The Secondary Treatment for Maxillofacial Fractures after the Unsuccessful Primary Treatment: a Report for 51 Cases
摘要
Abstract
Objective To investigate principle and methods of secondary treatment for maxillofacial fractures after the unsuccessful primary treatment.Methods Clinical data of 51 maxillofacial fractures patients with unsuccessful primary treatment was retrospectively analyzed.Results All the 51 patients were transferred to our hospital for the unsuccessful primary treatment, Among the 51 patients, there were 20 patients with postoperative infection, 14 patients with occluding relation disorders, 11 patients with limitation of mouth opening and 6 patients with facial deformity.During the secondary treatment, 39 patients were gotten rid of the primary titanium plates, in whom 21 patients underwent internal fixation with new plates, and 12 patients with old malunion fractures underwent orthognathic surgical correction therapy.After the operation, the 31 patients underwent intermaxillary elastic traction for 2-3 weeks combined with orthodontic and occlusal adjustment treatments, and patients were training in opening and closing mouth regularly.All the 51 patients had good healing of osteotomy segments, in whom 47 patients had satisfied occlusal relationship, masticatory function and face form symmetry after operations;4 patients with general satisfaction for occluding relation and further plastic reconstruction for facial figure;4 patients had poor occluding relation, and postoperative orthodontic treatment or occlusal adjustment treatments were required.After operation, 49 patients were followed-up, in whom 5 patients had moderate limitation of mouth opening in 3 months after surgery;7 patients had nerve injury, and the symptoms disappeared gradually in postoperative 3-6 months.Conclusion Postoperative complications can be treated by getting rid of old plates or performing internal fixation with new plate.Orthognathic surgical correction in treatment of old malunion fractures can achieve good effect, and postoperative complications of complex upper and lower maxillofacial fractures need multiple surgeries to achieve satisfactory effect.关键词
颌骨骨折/治疗失败/二期治疗Key words
Maxillofacial fracture/Treatment failure/Secondary treatment分类
医药卫生引用本文复制引用
王岳森,郭治辰,龚忠诚,李宏,姜德奇..颌面部骨折治疗失败后二期治疗探讨:附51例报告[J].临床误诊误治,2017,30(7):34-38,5.基金项目
国家自然科学基金(31260229) （31260229）
新疆维吾尔自治区青年科技创新人才培养工程项目(2014721046) （2014721046）
