下颌骨缺损游离髂骨移植骨块的准确就位及坚固固定  

Precise placement and rigid fixation of free iliac bone graft in reconstruction of mandibular defects

作　　者：潘瑾[1] 张益[1] 俞光岩[1] 

机构地区：[1]北京大学口腔医学院口腔颌面外科,100081

出　　处：《现代口腔医学杂志》2001年第3期182-184,共3页Journal of Modern Stomatology

摘　　要：目的　探讨游离髂骨移植修复下颌骨缺损过程中骨段的准确就位和坚固内固定方法。方法　按缺损范围 ,将 46例下颌骨缺损分为四种类型。应用术前、术中模板技术 ,同时参照标本及正常颌骨解剖形态 ,将髂骨块截开、分段塑形、就位。根据每类缺损的部位及特点 ,选择不同的坚固内固定方法和螺钉固位数目。结果　术后面形恢复良好 ,总体感染率 2 1.7% ,肿瘤复发率 2 %。术后 3～ 6个月X线片示骨痂形成。传统义齿修复率 13% ,种植义齿修复率 8.7%。结论　游离髂骨移植修复下颌骨缺损 ,应用模板技术可使植骨块准确就位 ;根据缺损的应力分布 ,选择最稳定的坚固内固定方法 ,则最终修复效果满意 ,感染率低。Objective To investigate the precise placement and rigid fixation of free iliac bone graft in reconstruction of mandibular defects.Methods The mandibular defects of 46 patients were devided into 4 types according to the extent.Referring to the templates,iliac bone grafts were cut into segments and shaped.Concerning the location and feature of every type of defects,the method of rigid inernal fixation and the number of screws were designed.Results All patients were satisfied with their final esthetic results.Infection rate was 21.7% in total.Recurrence rate of tumors was 2%.Callus formation was shown by X-ray films in 3～6 months after surgery.Conventional rehabiliation rate was 13%,implant-supported denture rate 8.7% .Conclusion Application of template and prepared-fixed reconstruction plate make the grafted bone placed precisely.The most stable internal fixation could be chosen based on the stress distribution of every type of defects.A satisfied final functional and esthetic result of free avascular iliac bone graft in mandibular reconstruction with a low infection rate could be obtained.

关 键 词：下颌骨缺损 游离髂骨移植 固定 

分 类 号：R782.24[医药卫生—口腔医学]