Intermaxillary fixation is not usually necessary to reduce mandibular fractures
Intermaxillary fixation is not usually necessary to reduce mandibular fractures
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DOI：
10.1054/bjom.1998.0372
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发表时间：
1999-02-01
影响因子：
1.8
通讯作者：
Hawkesford, JE
中科院分区：
文献类型：
--
作者：
Fordyce, AM;Lalani, Z;Hawkesford, JE
我们对纽卡斯尔总医院颌面部1年内需要积极治疗的所有孤立性下颌骨骨折进行了回顾性研究。下颌骨单一或多处骨折的患者被纳入研究;如果有其他面部骨骼同时骨折，这些患者被排除在外。所有病例记录和X线片均由一名操作员审查。共确定了202例下颌骨骨折病例，其中115例符合以下选择标准：孤立性骨折，既往无面部骨折，采用切开复位和钛接骨微型板内固定治疗，所有病例记录和X线片可用于研究。66例患者的骨折手动复位，以获得解剖复位，而无需使用术前颌间固定（IMF）。49例患者采用围手术期IMF进行常规治疗。两组骨折的严重程度和类型大致相似，复位方法似乎由术者根据其偏好决定。术后不常规使用IMF。总体而言，解剖复位治疗的患者术后早期咬合不正明显较少两种复位方法的最终疗效无显著性差异（6/66比16/49，P = 0.002），术中避免使用IMF在时间和费用上更为经济，对操作者更安全，对患者更舒适。由于这种技术在长期内产生了类似的结果，早期并发症较少，我们得出结论，IMF通常不是必要的，以减少骨折局限于下颌骨。
We undertook a retrospective study of all isolated mandibular fractures which had required active management over a 1-year period at the Maxillofacial Unit at Newcastle General Hospital. Patients with single or multiple fractures of the mandible were included in the study; if there were other simultaneous fractures of the facial skeleton, those patients were excluded. All case notes and radiographs were reviewed by a single operator. A total of 202 cases of fractured mandible were identified of which 115 fulfilled the selection criteria of: isolated fracture, no previous facial fracture, treatment by open reduction and internal fixation using titanium osteosynthesis miniplates, and all case notes and radiographs available to study.Sixty-six patients had their fractures reduced manually to obtain anatomical reduction without the use of peroperative intermaxillary fixation (IMF). Forty-nine were treated conventionally using peroperative IMF. The two groups were broadly similar in severity and type of fracture, and the method of reduction seemed to be decided by the operator according to their preference. IMF was not used routinely postoperatively.Overall there were significantly fewer occlusal discrepancies in the early postoperative period in those patients treated by anatomical reduction (6/66 compared with 16/49, P = 0.002) but there was no difference in the final outcome of the occlusion between the two methods of reduction.Avoidance of the use of peroperative IMF is more economical in time and cost, is safer for the operator, and more comfortable for the patient. As this technique produces comparable results in the long term with fewer early complications, we conclude that IMF is not usually necessary to reduce fractures confined to the mandibular bone.