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目的:探讨急诊时应用直丝弓技术治疗儿童颌骨骨折的可靠性和临床效果。方法:儿童单纯性颌骨骨折、无明显错位患者50例,男28例,女22例,平均年龄10.5岁。其中23例急诊时应用直丝弓技术,6例应用可吸收夹板作坚固内固定,21例作传统牙弓夹板固定,对3种方法的骨折愈合情况、张口度、骨折区牙齿咬合状况等进行疗效观察和对比,并对儿童单纯髁状突骨折疗效及治疗疼痛和口腔卫生做对比评价。结果:直丝弓组所有骨折均一期愈合,无感染、无错位愈合,咬合关系恢复正常。随访1个月至2年,无明显张口受限或继发畸形。内固定组2例出现咬合关系紊乱,传统牙弓夹板组4例出现感染,2例咬合不良,1例张口受限。在儿童单纯髁状突骨折病例中,固定正畸组咬合及咀嚼功能良好,治疗时口腔卫生及疼痛好于对照组。结论:急诊应用直丝弓技术治疗儿童颌骨骨折,疗效可靠,舒适度好,较内固定和传统牙弓夹板都具有明显的优点,可作为治疗儿童单纯性颌骨骨折的首选方法。
Objective: To investigate the reliability and clinical effect of using straight wire arch in emergency treatment of children jaw fracture. Methods: 50 cases of simple mandibular fracture in children without obvious dislocation, 28 males and 22 females, with an average age of 10.5 years. Among them, 23 cases were treated with straight wire arch technique in the emergency department, 6 cases were treated with absorbable splint for internal fixation, and 21 cases were used for traditional dental arch splint fixation. The fracture healing, mouth opening and fracture occlusion of the three methods were performed Efficacy of the observation and comparison, and children with simple condylar fracture efficacy and treatment of pain and oral health do comparative evaluation. Results: All fractures of straight arch group were healed one time, no infection, no dislocation healing, occlusal relationship returned to normal. Followed up for 1 month to 2 years, no obvious mouth restriction or secondary deformity. Two cases of internal fixation group occlusal disorders, the traditional dental arch splint group of 4 cases of infection, 2 cases of malocclusion, 1 case of limited mouth opening. In children with simple condyle fracture cases, fixed orthodontic group bite and chewing good, oral hygiene and pain treatment better than the control group. Conclusion: The application of straight wire arch in emergency treatment of children with mandibular fractures has reliable curative effect and good comfort. Compared with internal fixation and traditional dental arch splint, it has obvious advantages and can be used as the first choice for the treatment of simple jaw fracture in children.