下颌角骨折外斜线内固定失败的相关因素分析  

Related Factors Analysis on Failure of Mandibular Angle Fracture Treated by Internal Fixation on External Oblique Line

作　　者：任雯 向国林 REN Wen;XIANG Guolin(Department of Stomatology,Wuhan Fourth Hospital,Wuhan 430033,China)

机构地区：[1]武汉市第四医院口腔科,湖北武汉430033

出　　处：《口腔医学研究》2025年第3期226-228,共3页Journal of Oral Science Research

基　　金：武汉市卫健委科研项目(编号:WX23A08)。

摘　　要：目的:探讨通过在外斜线上进行内固定治疗下颌角骨折失败的相关因素。方法:回顾分析自2013年1月~2023年10月通过在外斜线上进行内固定治疗的39例下颌角骨折,根据患者术后复查的影像学资料判定是否出现内固定失败分为成功组和失败组,比较2组在年龄、性别、合并内科疾病、合并多发骨折、合并下颌第三磨牙、受伤至手术时间、术后感染、术后咬合关系不佳等因素的差异。结果:所有患者均获得1年以上随访,6例(15.38%)术后出现内固定失败,其中2例钛钉漂移,2例骨折缝增大,1例内固定折断,1例骨折端错位;其余患者骨折均愈合。单因素分析结果显示,成功组和失败组在合并多处骨折、术后感染及术后咬合关系恢复不佳存在差异。结论:通过在外斜线上固定下颌角骨折失败率仍较高,对于合并多处骨折的患者需要术前仔细评估确定方案,术后注意预防伤口感染,坚持颌间牵引调整咬合,降低术后内固定失败率。Objective:To explore the factors related to the failure of mandibular angle fractures treated by internal fixation on the external oblique.Methods:A retrospective analysis was performed on 39 cases of mandibular angle fractures treated with internal fixation on the external oblique line from January 2013 to October 2023.The patients were divided into the successful group and the failed group according to the image at postoperative review,and compared in terms of age,gender,combined medical diseases,combined multiple fractures,combined mandibular third molar,time from injury to surgery,postoperative infection,postoperative bite relationship,poor bite relationship,and other factors.Results:All patients were followed up for more than 1 year,and 6 patients(15.38%)had internal fixation failure after surgery,including 2 cases of titanium nail drift,2 cases of fracture suture enlargement,1 case of internal fixation fracture,and 1 case of fracture end dislocation.The fractures of the remaining patients were healed.The results of univariate analysis showed that there were differences between the successful and failed groups in the combination of multiple fractures,postoperative infection,and poor recovery of postoperative occlusal relationship.Conclusion:The failure rate of mandibular angle fracture fixed on the lateral oblique line is still high.Patients with multiple fractures need to be carefully evaluated and determined before surgery.Attention should be paid to prevent wound infection after surgery,and intermaxillary traction should be persisted to adjust the occlusion,so as to reduce the failure rate of postoperative internal fixation.

关 键 词：下颌角骨折 内固定失败 危险因素 

分 类 号：R68[医药卫生—骨科学]