急诊应用直丝弓技术治疗儿童颌骨骨折的探讨  

Application of straight wire appliance in the treatment of emergency oral maxillofacial fracture of children

作　　者：金旭斌[1] 郑晓丹[1] 龙小斯[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院口腔正畸科,武汉430022

出　　处：《临床急诊杂志》2011年第5期331-333,共3页Journal of Clinical Emergency

摘　　要：目的:探讨急诊时应用直丝弓技术治疗儿童颌骨骨折的可靠性和临床效果。方法:儿童单纯性颌骨骨折、无明显错位患者50例,男28例,女22例,平均年龄10.5岁。其中23例急诊时应用直丝弓技术,6例应用可吸收夹板作坚固内固定,21例作传统牙弓夹板固定,对3种方法的骨折愈合情况、张口度、骨折区牙齿咬合状况等进行疗效观察和对比,并对儿童单纯髁状突骨折疗效及治疗疼痛和口腔卫生做对比评价。结果:直丝弓组所有骨折均一期愈合,无感染、无错位愈合,咬合关系恢复正常。随访1个月至2年,无明显张口受限或继发畸形。内固定组2例出现咬合关系紊乱,传统牙弓夹板组4例出现感染,2例咬合不良,1例张口受限。在儿童单纯髁状突骨折病例中,固定正畸组咬合及咀嚼功能良好,治疗时口腔卫生及疼痛好于对照组。结论:急诊应用直丝弓技术治疗儿童颌骨骨折,疗效可靠,舒适度好,较内固定和传统牙弓夹板都具有明显的优点,可作为治疗儿童单纯性颌骨骨折的首选方法。Objective：To investigate the effect of straight wire appliance in the treatment of children emergency oral-maxillofacial fracture.Method：Fifty patients with simple fracture of jaws were included in the study,28 cases were male and 22 cases were female.The average age was 10.5 years old.23 cases were treated by technique of straight wire appliance,6 cases by fixation,and 21 cases by traditional retainers.Simple condylar fracture in children was evaluated.Result：There was no infection and fracture in the 13 cases treated by technique of straight wire appliance.The healing of the fracture surface was classified to class-Ⅰ and occlusion was norma1.In the following one month to two years,no abnormal eruption and secondary oral-maxillofacial deformity occurred.Two cases among the 6 cases treated by fixation had abnormal eruption and malocclusion.In group treated by traditional retainers,4 cases were infected,2 cases had malocclusion and 1 case had limitation of mouth opening.In group with condylar fracture,oral hygiene and pain during treatment was significantly better than control group using traditional retainers.Conclusion：The fixed orthodontic appliance has obvious advantages in the treatment of children with oral maxillofacial fracture,convinced by complete healing of fracture surface,normal occlusion and less complications.The fixed orthodontic appliance is the preferred option to treat children with oral maxillofacial fracture.

关 键 词：直丝弓 颌骨骨折 髁状突 儿童 

分 类 号：R782[医药卫生—口腔医学]