Method for treating the cases of edentulous mandible fracture

FIELD: medicine.

SUBSTANCE: method involves carrying out reduction and fixation of fractured bone fragments. At least two adjustable length rods are used. The rods have end heads and openings for making attachment to mandible. One of the heads is freely rotatable relative to the rod and the other one is movable along longitudinal rod axis. Reduction and fixation is made in positioned centric jaw relation. The rods are set between the mandible and maxilla to the right and left of the center at the level of failed second incisor and second bicuspid teeth.

EFFECT: reduced risk of traumatic complications; reduced periosteum detachment.

3 cl, 3 dwg

 

The invention relates to medicine, namely to oral and maxillofacial surgery, and can be used in the treatment of fractures of the edentulous mandible.

There is a method of treatment of fractures of the edentulous mandible by open reposition of fragments of the lower jaw and their fixation titanium mini-plate (Chebotarev, SJ Comparative analysis of different methods of surgical treatment of mandibular fractures: Dis. Kida. the honey. Sciences: 14.00.21/state medical University n.a. akeelah - St. Petersburg, 1999. - 54 S.).

The main disadvantage of this method is the necessity of extensive detachment of the periosteum, which is an important source of blood supply to the jaw, as well as conducting operations under General anesthesia, which is associated with certain risks.

The objective of the invention is to provide a method of treatment of fractures of the edentulous mandible with less traumatic, less risk of arthrosis and arthritis temporomandibular joint, simpler to implement.

The problem is solved in that in the known method of treatment of fractures of the edentulous mandible, including the reduction and fixation of bone fragments, according to the invention using at least two rods of adjustable length with heads at the ends, with holes for fixing to the jaw, and one head is mounted with the option of free rotation relative to the rod, and the other can move along the longitudinal axis of the rod; reposition and fixation is carried out at positioned the Central value of the jaws, rods installed between the upper and lower jaws left and right of the center at the level of missing second incisors and second premolars.

It is advisable fractures in the angle of the jaw to reposition and fixation of bone fragments to install additional rod between the upper and lower jaws so that its lower end was on the smaller fragment.

It is advisable to install the studs for the jaw bone to make pre-cuts-punctures at the appropriate level, dissecting this mucosa, submucosa and the periosteum, and between sections of the punctures of upper and lower jaws to install the rods.

In the proposed method of treatment of fractures of the edentulous mandible authors first use premaxillary fixation rods of adjustable length that can safely and easily carry out the reduction and fixation of bone fragments. For premaxillary fixation rod enough run-cuts-punctures on the upper and lower jaw, which is less traumatic than the detachment of the periosteum. Fixation when positioned Central value of the jaws provides an accurate mapping of the jaws that smart which increases the risk of developing arthritis and arthritis temporomandibular joint.

The present invention is illustrated in the drawings, figure 1-3.

Figure 1 shows a General view of the rod of adjustable length, used in the proposed method.

Figure 2 shows a photograph of the patient Leningrad after the installation of the two rods of the proposed method.

Figure 3 shows orthopantomogram patient L.

The method is carried out, for example, as follows.

At admission the patient to the hospital removed the casts of the jaws for diagnostic models. Determine the Central value of the jaws and is made of plastic positioner. The positioner is installed in the oral cavity and fix the alveolar processes of the jaws in the Central division. Under infiltration anesthesia on the alveolar ridge of the upper jaw and the alveolar part of the mandible in the area of the missing second incisors and second premolars perform incisions-punctures on the width of the blade of the scalpel, dissecting the mucosa, submucosa and the periosteum of the jaws. Install hollow titanium rods 1 adjustable length between cuts-punctures the upper and lower jaw on the left and right sides so that the head 2.3 rods were located at the level of cuts-punctures. Through the holes of 4.5 in the heads of 2.3 bars 1 is fixed to the corresponding bone of the jaw standard titanium is diversified screws for osteosynthesis of length 1, see Then carry out the reduction and fixation of bone fragments by rotation of the rods 1 as long as they do not set the bone fragments of the lower jaw in the correct position. Adjustment of the rod length shall exercise due to the threaded connection head 2 with terminal 1, while the head 3 is coaxially connected to the rod 1 by means of cotter pins through the holes 6 and does not prevent the free rotation of the rod 1. If a fracture of the lower jaw is held in the angle of the jaw, the lower head 2 or 3 of one of the rods 1 is installed on the smaller fragment and rotation of the rod 1 are reposition of bone fragments. After performing radiological control the positioner is removed. Once a week perform activation of screws through holes 7 activation. 4 weeks after installation, the rods are removed.

The method is illustrated by the following example.

Example. Patient L., aged 65. Diagnosis: fracture of the mandible in the area 43 of the tooth offset, the absence of teeth. For admission for treatment of a fracture applied the proposed method. For fixing used 4 rod of adjustable length (figure 2, 3). The course lymphotropic antibiotic therapy. The rods removed 4 weeks after fixation. There was a full bone healing wound, fracture fragments. Infectious-inflammatory complications were noted.

Offer is aemy method is effective in the treatment of fractures of the edentulous mandible in patients of older age groups. The method is simple to implement. Ease of hygiene and professional cleaning rods provides the use of the method in individuals with intellectual disabilities. Adjust the length of the rod makes its use is universal, there is a possibility of reusable cores.

1. A method of treatment of fractures of the edentulous mandible, including the reduction and fixation of bone fragments, characterized in that use at least two rods of adjustable length with heads at the ends, with holes for fixing to the jaw, and one head is mounted with a possibility of free rotation relative to the rod, and the other can move along the longitudinal axis of the rod, reposition and fixation is carried out at positioned the Central value of the jaws, rods installed between the upper and lower jaws left and right of the center at the level of missing second incisors and second premolars.

2. The method according to claim 1, characterized in that the fractures in the angle of the jaw to reposition and fixation of bone fragments install additional rod between the upper and lower jaws so that its lower end was on the smaller fragment.

3. The method according to claim 1 or 2, characterized in that the installation of the rods on the jaw bone pre do RA is the cut-punctures at the appropriate level, dissect this mucosa, submucosa and the periosteum, and between sections of the punctures of upper and lower jaws set the rods.



 

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