악간고정 없는 하악골 골절의 관혈적 정복술 - 후향적 연구

이충현; 김철환

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악간고정 없는 하악골 골절의 관혈적 정복술 - 후향적 연구
Open reduction of mandibular fracture without maxillomandibular fixation : retrospective study

대한구강악안면외과학회지 2011년 37권 4호 p.255 ~ 263

이충현, 김철환,

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이충현 ( Lee Chung-Hyun ) - 단국대학교 치과대학 구강악안면외과학교실
김철환 ( Kim Cheol-Whan ) - 단국대학교 치과대학 구강악안면외과학교실

KMID : 0355620110370040255

Abstract

Introduction: Maxillomandibular fixation (MMF) is essential before surgery under general anesthesia in maxillofacial trauma patients. MMF is used basically to reconstruct the occlusion and occlusal stability to recover the facial shape and oral functions. The arch bar and wire is a traditional method for MMF, but it can not only bring pressure to the periodontal ligaments and teeth but also cause a penetrating injury to the surgeons.

Materials and Methods:In this study, 198 patients with an open reduction using a manual reduction without MMF from September 2005 to May 2010 in Dankook University Dental Hospital were subjected to a follow-up evaluation during the postoperative 4 months periods. This study evaluated the incidence of complications according to the condition of the patient (gender, age), the state of bony union of the fracture sites and a numeric rat￢ing scale evaluation for postoperative pain scoring.

Results: 1. The complications were classified into major and minor according to the seriousness, and the major complication rate was as low as 2.02%. Only 2 cases of re-operations (1.01 %) were encountered. In the classification according to the fracture line, plate fracture was observed in both cases of mandibular symphysis fracture, and angle fractures and loosening of two screws were noted in the case of mandibular angle fracture. 2. The complication rate was similar regardless of gender and age. 3. The degree of bony union was satisfactory, and the complication rate was reduced as the bony union improved. 4. More patients complained of pain as the operation time was increased.

Conclusion: The use of MMF is not always necessary if a skilled assistant is provided to help manually reduce the fracture site. Compared to other studies of mandibular fracture surgery using MMF, the complication rate was similar using only manual reduction and the patients’ discomfort was reduced without MMF.