Clinical Experience with Poly-L/DL-Lactide 90/10 Absorbable Plates for Mandibular Fracture Fixation

可吸收骨板在單純下頷骨骨折的運用與初步結果

蔡政龍(John-Long Tsai) ； 陳建宗(Chien-Tzung Chen) ； 郭世偉(Shih-Wei Kuo) ； 廖漢聰(Han-Tsung Liao)

《臺灣整形外科醫學會雜誌》 19卷2期 (2010/06) Pp. 95-103

https://doi.org/10.7096/TJTSPS.201006.0095

摘要

背景：
鈦金屬骨板仍然是顏面骨骨折固定的治療主流。可吸收骨板從60s 年代問世以來，經過多次的改良，也逐漸的使用在顴骨骨折復位及顱骨等較不受力的部位。可吸收骨板也逐漸的開始使用在下頷骨骨折的病人身上。但是，骨板本身能否提供一個可接受得強度來固定骨折處則是一主要的考量。
目的及目標：
證明可吸收骨板有足夠的剛性可以固定單純的下頷骨骨折，並達到治療及復位的療效。
材料及方法：
本文選了十七位下頷骨單純骨折病人，骨折處為一到二處，無呼吸道阻塞且其有足夠的牙齒來評估術後咬合情形。使用可吸收骨板固定骨折處。
結果：
術後一年，由顏面電腦斷層追蹤發現，所有病人的骨折處癒合良好，術後咬合功能良好，且術後滿意度也很高。
結論：
本研究顯示，可吸收骨板可以使用於單純的下頷骨骨折。

並列摘要

Background:
Titanium plate fixation is still the standard treatment for mandibular fracture. The major drawback concerned by patients is the need of secondary operation for removing plates due to its non-degradable property. In contrast, the absorbable plate can be degraded gradually after the fracture is healed. However, the absorbable plate was mainly applied in non-loading areas such as mid-facial or zygomatic fixation in the past. The application of absorbable plate in load-bearing mandible fracture is still controversial due to its lower strength than titanium plate.
Aim and objectives:
The aim and objectives of this study is to evaluate whether absorbable plates can be applied in the management of simple mandibular fracture and obtain adequate anatomical reduction, bone union and acceptable functional result on a long term basis. Materials and methods:
From January 2007 to January 2008, patients who were admitted due to mandibular fractures and received absorbable plates for fixation were enrolled for study. Inclusionary criteria were: simple fracture in one or two sites, no airway compromise or major infectious disease, sufficient number of teeth for achieving stable occlusion. All patients in the study were followed for one year. The bone healing was evaluated with facial CT scan. Patients' satisfaction rate was scored by a visual analogue scale.
Results:
Twelve male and five female patients were included in this study. The mean age was 28 ± 10 years old. Twenty-two fracture sites were managed in this study. Excellent bone healing and high patient satisfaction were noted after one year follow-up. Patients also regained good occlusion and masticatory function.
Conclusion:
This study demonstrated that the absorbable plating system could achieve adequate fixation strength for simple mandibular fracture in one or two sites. Thus, we recommended that absorbable plates could be an alternative choice in fixing the simple mandibular fracture.

並列關鍵字

absorbable plates ； mandibular fracture ； Poly-L/DL-Lactide 90/10