Application of pure titanium lag screw in condyle fracture Guo Qi () Ji Wei () Liu Hongpeng (高莺 () Sun Min (1) Zhang Ruisheng ((Ministry of Police, Shanxi General Hospital, Department of Stomatology 030006 2 Shanxi Taihang Instrument Factory)~2001- 07, we used pure titanium lag screw (TSO) for axial lag screw fixation of mandibular condyle fracture, the surgical results are satisfactory, the report is as follows: 1 data and methods general data selection of 9 cases of condylar joint capsule transverse fracture The patients were 6 males and 3 females, aged 18-63 years, with an average age of 36. There were 4 cases of left condylar fracture, 3 cases of right condylar fracture, and 2 cases of bilateral fracture. There were 5 cases of fracture, 4 cases of medial displacement, 2 cases of lateral displacement, 2 cases of anterior displacement, and 1 case of no significant displacement.
1.2 Surgical materials are made of pure titanium raw materials provided by Beijing Nonferrous Metals Research Institute. They are processed into pure titanium lag screws by Shanxi Taihang Instrument Factory, with a diameter of 2mm and lengths of 45, 50, 55, 60, 65, 70mm. The end 10mm has a self-tapping leather thread, the middle section is unthreaded, and the rear section is provided with a free end with a nut sleeve.
Methods Seven patients with unilateral condylar fractures underwent local anesthesia, and two patients with bilateral condylar fractures underwent general anesthesia after nasal cannulation. First, the fracture of the mandibular fracture was performed in the mouth. The small titanium plate internal fixation was performed, then the lag screw reduction and fixation of the condylar fracture was performed. The lower margin of the mandibular angle was used to expose the fracture area, and the mandibular ascending branch of the fracture line was used. The long axis line is ground with a ball drill to remove the buccal bone, forming a window. The lower mandible is connected to the fenestration by a split drill between the inner and outer cortical bones of the mandibular ascending branch. After the tunnel is directly viewed, use a split drill to make a hole in the condylar fracture end. Screw the corresponding length of the lag screw along the tunnel and screw the tip thread into the condylar end. Screw the end of the lag screw at the corner of the mandible. The fracture end of the condylar fracture was tightened and fixed. After the normal occlusion relationship was reviewed, the upper and lower arch splints and the intermaxillary fixation were removed, and the incision was sutured.
2 Results -9 patients with postoperative incision healed in the first stage. Clinical examination showed no joint pain and facial asymmetry, and the occlusion was good. The postoperative follow-up period was 3 years, the shortest 5 months, 1 case of open type to 2 mm of the contralateral side, and 1 case of opening degree of 32 mm. In 7 cases, the maximum mouth opening and lateral movement were achieved.
3 Discussion of the advantages of TSO fixation This technology is a new technology that has emerged in recent years. Only a few countries in the world report that only Lin Ye has done related research in China. We used 9 cases of mandibular condylar fractures to fix and fix the mandibular condylar fractures by using pure titanium axial lag screw. The technique of axial lag screw reduction and fixation was used to fix the condylar fracture, restore the physiological function of the condyle and prevent complications. The surgical method has obvious advantages. This conclusion is consistent with the results of Lin Ye et al.
There are many treatments for condylar fractures, and the current view is that different treatments should be chosen depending on the type of fracture. It is generally believed that severely displaced or dislocated condylar fractures, especially those with forward and internal displacement, should be cut open early. Compared with other methods, TSO reduction and fixation uses a simple mandibular angle incision, which is simple and concealed. The probability of causing hemorrhage and facial nerve injury is greatly reduced, and the fracture end can be restored and fixed through tunnel under direct vision, and the fixation effect is reliable. There is no need for intermaxillary ligation after surgery. In addition, TSO fixation fully utilizes the principle of biomechanics. It can be used to reset the condylar fracture at the mandibular angle by screwing the condylar screw into the self-tapping screw. It is more convenient than the traditional Kirschner wire fixation and the materials used. It is titanium metal, has good biocompatibility, is non-toxic and corrosive, and requires no secondary surgery.
In general, TSO fixation indications can be used to reset fixed condylar fractures. Most of them can also be fixed with TSO, but this method is not suitable for sagittal sagittal fracture with dislocation. It is mainly used for the transverse fracture of the mandibular condyle joint.
The problem that should be paid attention to when using TSO fixation is to first restore the fracture end before the lag screw fixation, and use the intermaxillary ligation to ensure the occlusal relationship, especially the difficulty of exposure and reduction of the fracture end of the mandibular ascending branch. Large, requires the surgeon to have a higher operating technique. If tunnel preparation is performed without an accurate reset, satisfactory surgical results will not be obtained. Secondly, the screwing direction of the screw should always be along the axis, and it should not be skewed, otherwise it is easy to wear sideways. Furthermore, it is also necessary to master the length of the screw to avoid penetrating the top of the condyle.
In short, TSO fixation is an emerging method for the reduction and fixation of condylar fractures. It has many incomparable advantages compared with other methods. The application prospect is very broad and it is worthy of clinical promotion.
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