39例颌骨重建固定钛板取出原因分析  

Analysis of 39 Cases with Mandible Reconstruction and Fixation Failure by Using Titanium Plates

作　　者：陆东辉[1] 金友仁[1] 汪海波[2] 吴云志[2] 

机构地区：[1]南京大学医学院附属口腔医院颌面外科,江苏南京210008 [2]南京医科大学附属第二医院神经外科

出　　处：《口腔医学研究》2008年第5期554-556,共3页Journal of Oral Science Research

摘　　要：目的:本文通过39例颌骨因肿瘤或骨折复位开放内固定术后钛板取出原因分析,探讨临床减少或者避免产生上述并发症的可能性。方法:收集因颌骨切除后植入钛板修复重建失败和骨折复位开放内固定术后再入院行钛板取出术共计39例临床病案资料,进行回顾性分析研究。结果:因感染原因取出内置钛板共计22例,其中肿瘤术后重建组14例含放疗后患者8例,骨折内固定组8例。非感染因素取出内置钛板12例,其中肿瘤术后重建组7例,骨折内固定组5例。生理性不适取出5例。钛板取出时间最短为术后3周,最长8年,平均为术后6个月。结论:术后感染是钛板植入后失败取出的主要原因,特别是恶性肿瘤术后放疗更加剧了感染的危险性。钛螺钉松脱或钛板折断移位以及创缘张力过大(裂开)是钛板重建或固定术后感染的直接因素。颌力负担及钛板桡曲力度大小与植入钛板稳固性密切相关。Objective： To study the possibility to avoid the complications associated with mandibular reconstruction and titanium plates fixation. Methods： 39 patients with mandible reconstruction and titanium plates fixation failure were analysed retrospectively. Results： 22 of the failure were caused by infection, 12 of the failure were caused by plates and screws loosening without infection, and the others were caused by physical discomfort. The average period of titanium plates removal was 6 months postoperative, Conclusion： Infection of the wound is the main cause of the failure of titanium plates, especially irradiation damage. Plates and screws loosening leads to a lack of stability in combination with pre - existing or new infection. Biting force and bending resistance are associated with the plates stability.

关 键 词：钛板 重建 内固定 颌骨 

分 类 号：R782.2[医药卫生—口腔医学]