CAJ | 학술논문

目的对下颌骨骨折内固定术后拆除小型接骨板前后应力遮挡效应进行回顾性临床研究,为下颌骨骨折愈合后内固定材料的远期处置提供理论依据.方法 18例下颌骨骨折愈合后取出钛接骨板患者,按照内固定术时间分为3个月组、4个月组及6个月组,分别在骨折内固定术前、内固定3、4、6个月取出钛接骨板后以相同条件拍摄全口曲面体层X线片,测量以钉孔为中心、直径为1 cm范围骨密度的灰度值,将内固定前与拆除接骨板后同一位置的骨密度进行自身对比.结果内固定3个月组术前骨密度(125.41±2.47)和拆除接骨板后(120.19±3.52)骨密度灰度值结果比较,差异无统计学意义(P＞0.05);4个月组拆除接骨板后骨密度灰度值(109.19±10.65)低于术前(131.32±13.05)(P＜0.05);6个月组拆除接骨板后骨密度灰度值(90.78±4.87)明显低于术前(135.26±3.43)(P＜0.01).拆除接骨板后,18例未出现继发骨折.结论骨折内固定4、6个月后出现了应力遮挡的负面效应,应该拆除接骨板.
목적 대하합골골절내고정술후탁제소형접골판전후응력차당효응진행회고성림상연구,위하합골골절유합후내고정재료적원기처치제공이론의거.방법 18례하합골골절유합후취출태접골판환자,안조내고정술시간분위3개월조、4개월조급6개월조,분별재골절내고정술전、내고정3、4、6개월취출태접골판후이상동조건박섭전구곡면체층X선편,측량이정공위중심、직경위1 cm범위골밀도적회도치,장내고정전여탁제접골판후동일위치적골밀도진행자신대비.결과 내고정3개월조술전골밀도(125.41±2.47)화탁제접골판후(120.19±3.52)골밀도회도치결과 비교,차이무통계학의의(P＞0.05);4개월조탁제접골판후골밀도회도치(109.19±10.65)저우술전(131.32±13.05)(P＜0.05);6개월조탁제접골판후골밀도회도치(90.78±4.87)명현저우술전(135.26±3.43)(P＜0.01).탁제접골판후,18례미출현계발골절.결론 골절내고정4、6개월후출현료응력차당적부면효응,응해탁제접골판.
Objective To investigate the stress shielding after mini-plate internal fixation for mandibular fractures. Methods Eighteen patients with mandibular fractures were selected. X-rays were taken before operation and 3,4, 6 months after operation when the plates were removed. The bone density of the mini plate area was examined and compared among different time interval groups. Results The bone density before operation ( 125.41 ± 2. 47 ) and 3 months after operation ( 120. 19 ± 3.52 ) was not significantly different, but became lower 4 and 6 months after operation than before operation. Conclusions There appeared stress shielding after internal fixation for 4 and 6 months in mandibular fracture,and the mini plate should be removed at those times.