하악 우각부 골절 시 2개의 miniplate를 이용한 관혈적 정복술에 대한 전향적 예비 임상연구
The prospective preliminary clinical study of open reduction and internal fixation of mandibular angle fractures using 2 miniplates
양승빈, 장창수, 김주원, 임진혁, 김좌영, 양병은,
소속 상세정보
양승빈 ( Yang Seung-Bin ) - 한림대학교 의과대학 구강악안면외과학교실
장창수 ( Jang Chang-Su ) - 한림대학교 의과대학 구강악안면외과학교실
김주원 ( Kim Ju-Won ) - 한림대학교 의과대학 구강악안면외과학교실
임진혁 ( Yim Jin-Hyuk ) - 한림대학교 의과대학 구강악안면외과학교실
김좌영 ( Kim Jwa-Young ) - 한림대학교 성심병원 구강악안면외과학교실
양병은 ( Yang Byeong-Eon ) - 한림대학교 의과대학 구강악안면외과
KMID : 0355620100360040320
Abstract
Introduction: The placement of a single miniplate is not sufficient to achieve rigid fixation in mandibular angle fractures. It often causes difficulties in reducing the intermaxillary fixation (IMF) period. Consequently, the placement of 2 miniplates is preferable. The intraoral approach in an open reduction and internal fixation (ORIF) of a mandibular angle fracture with 2 miniplates is often challenging. Accordingly, an alternative of transbuccal approach is performed. However, this method leaves a scar on the face and can result in facial nerve injury. This clinical study suggests a protocol that can maintain rigid fixation without a transbuccal approach in mandibular angle fractures.
Materials and Methods: The subjects were 7 patients who sustained fractures of the mandibular angle and treated at Department of Oral and maxillofacial surgery, Sacred Heart Hospital, Hallym University. ORIF under general anesthesia was done using the intraoral approach. One miniplate was inserted on external oblique ridge of the mandible, and the other was placed on lateral surface of the mandibular body with contra-angle drill and driver. A radiographic assessment and occlusal contact point examination was carried out before surgery, and 2, 4 and 6 weeks after surgery.
Results: The mean operation time was 80 minutes. Regarding the occlusion state, the number of contact points increased after surgery. Paresthesia and infection were reported to be complications before surgery.
Conclusion: The placement of 2 miniplates using contra-angle drill for ORIF of mandibular angle fractures allows early movement of the mandible without IMF. We propose this approach to reduce the patients’discomfort and simplify the surgical procedure.
키워드
Mandible; Angle fracture; Contra-angle drill; Intra-oral approach
원문 및 링크아웃 정보
등재저널 정보