摘要
目的 探讨腓骨复合瓣重建下颌骨缺损时骨块的塑形、定位和固定方法。方法 15例患者根据下颌骨六种缺损类型 ,对腓骨进行截骨塑形 ,按定位钢板定位后的下颌骨缺损形态和长度准确就位 ,小钛板或重建板进行坚固内固定。结果 15例腓骨复合瓣重建下颌骨缺损全部获得成功。腓骨截成二段者 8例 ,三段者 3例 ,4例未截断。术后面部外形恢复满意者 13例 ,咬合关系正常者 12例 ,张口度正常者 14例 ,3例患者术后接受活动义齿修复 ,1例种植义齿修复并获得良好的咀嚼功能。结论 腓骨复合瓣可根据下颌骨缺损的部位和形态进行截断塑形 ,定位钢板能保证移植骨块的准确就位 。
Objective To investigate the shaping, placement and fixation of fibula free flap in reconstruction of mandibular defects. Methods 15 patients with mandibular defects were reconstructed with fibula free falp. The mandibular defects were classified into 6 types according to the resected extent. Concerning the location and feature of every type of defects, the fibula flaps were cut into 2～3 segments, bent to appropriate shape, placed and rigid fixed with titanium mini plate or reconstruction plate. Results All the 15 fibula free flaps survived well without failure. The wounds healed well. Of these patients, 2 cases were type Ⅰ, 4 were type Ⅱ,3 were type Ⅲ, 3 were type Ⅳ,2 were type Ⅴand one was type Ⅵ. The fibula flaps were divided into 2 segments in 8 cases, 3 segments in 3 cases. 13 patients were satisfied with their final esthetic results. 12 patients were obtained normal occlusal relationship and 14 patients were achieved normal degree of mouth opening. But, the conventional rehabiliation rate was only 20 %(3/15). Conclusion The fibula flap could be cut into segments and shaped according to the location and shape of mandibular defects. The application of templates make the fibula flaps placed precisely. The rigid internal fixation could be chosen based on the stress distribution of every type of defects, therefore, a stable graftedbone could be obtained.
出处
《临床口腔医学杂志》
2002年第2期120-121,共2页
Journal of Clinical Stomatology
关键词
腓骨复合瓣
下颌骨缺损
坚固内固定
义齿
Fibula free flap
Mandibular defect
Shaping
Placement
Rigid internal fixation
