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作者在临床实践中采用一种全新颌间固定方法,在颊沟牙槽骨旋人颌间结扎钛钉,以钛钉为固定源行颌间牵引固定,较传统方法更方便、有效1 资料与方法 一般资料 颌骨外伤骨折致咬合关系错乱患者25例,男18例,女7例 年龄19～43岁 其中上颌骨骨折8例,下颌骨骨折13例,上下颌骨联合骨折4例 单发性骨折3例,多发性骨折22例21例在全麻下行骨折切开复位钛夹板内固定,术中采用新颌间固定法4例患者不愿接受手术在局麻下行新颌间固定法牵引复位.新的颌间固定法 在颊沟粘膜转折处用微型电钻打孔,直接穿过牙龈达牙槽骨内,旋入10mm,直径20mm专用颌间结扎钛钉,在双侧上下颌尖牙与第一双尖牙间及第1与第2磨牙间旋入钛钉,每侧上下颌各旋入钛钉2个 在上下颌牙齿相应处栓扎钢丝,暂时固定已切开复位骨折,然后行纯钛夹板内固定.确定恢复伤前咬合关系后去除栓扎钢丝.保留颌间固定钛钉,术后继续橡皮筋牵引固定1周.未切开复位患者,在颌间固定钛钉上挂橡皮筋牵引复位3～4周2 结果 牵引固定期间颌间固定钛钉稳固,未见松动及脱落,而型及咬合关系均恢复正常.无一例发生感染,牙齿无不适感,口内无明显异物感 折除钛钉后 3～5天骨孔愈合其中5例因牙槽嵴畸形突起,牵引橡皮筋直接压迫致牙龈溃
The author in clinical practice using a new method of intermaxillary fixation, alveolar bone in the buccal alveolar ligation of titanium nail, titanium nail as a fixed source of intermaxillary traction fixation, more convenient and effective than the traditional method 1 data and Methods Twenty-five patients (18 males and 7 females, aged 19-43 years) with upper malleolus fracture, 13 mandibular fractures, 4 maxillary and mandibular fractures were included in this study. 3 cases of fracture, 22 cases of multiple fractures in 21 cases underwent general anesthesia underwent fracture reduction and reduction of titanium splint fixation, intraoperative use of new intermaxillary fixation method in 4 patients were reluctant to accept surgery under local anesthesia under the new intermaxillary fixation traction reduction The new intermaxillary fixation method in the buccal mucosa turning point with a mini drill drilled directly through the gums up to the alveolar bone, screwed into the 10mm, 20mm diameter special intermaxillary ligation of titanium nails in the bilateral maxillary canine and Between the first pair of canines and between the first and second molars, titanium screws were screwed into each of the upper and lower jaws, and two titanium screws were screwed into the upper and lower jaws to fasten the steel wire. The open reduction fracture was temporarily fixed Pure titanium splint internal fixation to determine the restoration of pre-occlusion relationship to remove the bolting wire Mandibular fixation of titanium nail, the continued traction of rubber band for 1 week after surgery.Until open reduction patients, in the intermaxillary fixation of titanium nail hanging rubber band traction reduction 3 ~ 4 weeks 2 results during traction Fixed intermaxillary fixation of titanium nails, No loosening and loss, and the type and occlusion were back to normal .None of the cases of infection, no discomfort in the mouth, no significant foreign body sensation In 3 to 5 days after the removal of titanium nail bone healing in 5 cases due to alveolar ridge deformity Protrusion, traction rubber band direct compression caused gum collapse