目的:本研究旨在探讨三种不同的接骨板系统对同种异体重建连续中断下颌骨切除后的故障率和并发症的影响。
方法:对2010-2020年患者的资料进行回顾性分析。分析包括接骨板类型(2.4下颌骨(RP1:下颌骨[Medicon®,Tuttlingen,德国];RP2:Modus®Reco2.5[Medartis®,巴塞尔,瑞士];和RP3:Modus2下颌骨[Medartis®,巴塞尔,瑞士]),缺陷的范围和位置,年龄,性别,放射治疗,尼古丁滥用。如果失败,时间点,和问题,即口腔/口外裂开,螺钉松动,和导致切除的钢板骨折,进行了分析。根据Clavien-Dindo系统对并发症进行分类。
结果:共纳入136例患者。平均随访时间为18±26个月。术后1年、2年和5年生存率分别为69.9%,66.9%,和64.7%,分别。尽管生存率与重建系统没有显着相关,与RP3相比,RP1和RP2的并发症最常见(p=0.033).简而言之,与RP1(44.7%)和RP2(26.9%;p=0.024)相比,RP3(12.5%)的开裂发生率明显较低。使用RP1的4例中有3例(75%),使用RP2的4例中有1例(25%),没有使用RP3系统的单个病例(p=0.03)。大多数观察到的并发症发生在术后12个月。观察到总的板生存率为64.7%,总的板并发症发生率为47.8%。
结论:结论:在失败率和并发症方面,RP3应该优于RP1和RP2.
OBJECTIVE: This study aimed to investigate the effect of three different osteosynthesis plate systems on failure rates and complications after continuity-interrupting mandibular resections with alloplastic reconstructions.
METHODS: Records of respective patients from 2010 to 2020 were analyzed retrospectively. The analyses included the osteosynthesis plate type (2.4 MANDIBULAR (RP1: MANDIBULAR [Medicon®, Tuttlingen, Germany]; RP2: Modus® Reco 2.5 [Medartis®, Basel, Switzerland]; and RP3: Modus 2 Mandible [Medartis®, Basel, Switzerland]), extent & location of the defect, age, sex, radiotherapy, and nicotine abuse. In case of failure, timepoint, and the problem, namely oral/extraoral dehiscence, screw loosening, and plate fractures that led to removal, were analyzed. Complications were classified according to Clavien-Dindo system.
RESULTS: A total of 136 patients were included. The mean follow-up time was 18 ± 26 months. Survival rates after 1, 2, and 5 years were 69.9%, 66.9%, and 64.7%, respectively. Although survival was not significantly associated with the reconstruction system, the most frequent complications were seen in cases of RP1 & RP2 when compared to RP3 (p = 0.033). In brief, dehiscences were seen significantly less often in cases of RP3 (12.5%) when compared to RP1 (44.7%) and RP2 (26.9%; p = 0.024). Fractures of the osteosynthesis systems occurred in 3 of 4 cases (75%) with RP1, in 1 of 4 cases (25%) using RP2, and in no single case using the RP3 system (p = 0.03). Most of the observed complications occurred up to 12 months postoperatively. A total plate survival rate of 64.7% and a total plate complication rate of 47.8% were seen.
CONCLUSIONS: In conclusion, it seems that RP3 should be preferred over RP1 and RP2 regarding failure rates and complications.