악골절 치료후 부정유합에 관한 임상적 연구

• 영문명: Malunion of the Jaw Fractures Complicated Following the Primary Managements
• 발행기관: 대한구강악안면외과학회
• 저자명: 김대성(Dae Sung Kim) 김명래(Myung Rae Kim) Jang Woo Choi
• 간행물 정보: 『대한구강악안면외과학회지』대한구강악안면외과학회지 제25권 제4호, 356~360쪽, 전체 5쪽
• 주제분류: 의약학 > 내과학
• 파일형태: PDF
• 발행일자: 1999.10.30

영문 초록

PURPOSE : This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS & METHODS : Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of refracture and ORIF in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(l6/29), and camouflage countering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS : Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.

목차

Abstract

Ⅰ. 서론

Ⅱ. 연구대상 및 방법

Ⅲ. 연구결과

Ⅳ. 총괄 및 고찰

Ⅴ. 결론

참고문헌

키워드

Fractures Malunion Revision