新型数字化腓骨转移固定导板在下颌骨缺损重建术中的应用

doi:10.19438/j.cjoms.2025.01.008

摘要/Abstract

摘要： 目的：探讨新型数字化腓骨转移固定导板用于下颌骨重建术中的效果。方法：选择2021年9月—2023年7月新疆医科大学第一附属医院收治的因下颌骨缺损需行腓骨肌皮瓣修复重建的患者11例,其中,试验组（n=5）术前3D打印腓骨转移固定导板、腓骨截骨塑型导板,术中按照导板指示截骨并塑型;对照组（n=6）采用传统截骨导板进行腓骨截骨及塑型。比较2组患者术中相关指标、术后并发症发生情况,以及术前,术后2周、1个月、3个月的颞下颌关节功能状况。采用SPSS 26.0软件包对数据进行统计学分析。结果：试验组总手术时长及皮瓣缺血时间显著少于对照组（P<0.05）,下肢功能评价显著优于对照组（P<0.05）。2组患者术后最大开口度、左侧方运动范围、右侧方运动范围、前伸运动范围均是先下降后逐渐上升。术后1个月,试验组前伸运动范围显著大于对照组（P<0.05）,其余指标2组间无显著差异（P>0.05）。结论：新型数字化腓骨转移固定导板在下颌骨重建术中具有良好的指引手术功能,术中精确切除病灶骨段并确保了残存骨的位置、髁突位置和咬合关系,降低手术时长,减少皮瓣缺血时间。

关键词: 腓骨转移固定导板, 腓骨肌皮瓣, 下颌骨缺损, 数字化设计

Abstract: PURPOSE: To investigate the effect of a new digital fibular transfer and fixation guide in mandibular reconstruction. METHODS: A total of 11 patients with mandibular defects who underwent fibular flap reconstruction in the First Affiliated Hospital of Xinjiang Medical University from September 2021 to July 2023 were collected. In the experimental group (n=5), the fibular transfer and fixation guide plate and the fibular osteotomy molding guide plate were printed before operation, and the osteotomy and shaping were performed according to the instructions of the guide plate during operation. In the control group (n=6), traditional osteotomy guide plate was used for fibula osteotomy and shaping. The evaluation of related indicators during operation, the occurrence of postoperative complications, and the evaluation of temporomandibular joint function before operation, 2 weeks, 1 month and 3 months after operation were compared between the two groups. SPSS 26.0 software package was used for data analysis. RESULTS: The total operation time, intraoperative blood loss and flap ischemia time in the experimental group were significantly less than those in the control group (P<0.05). The lower extremity function of the experimental group was significantly better than that of the control group(P<0.05). The maximum postoperative opening degree, left side range of motion, right side range of motion and extension range of motion in 2 groups decreased first and then gradually increased. One month after operation, the range of extension motion in the experimental group was significantly greater than that in the control group (P<0.05), but there was no significant difference in other indexes between the two groups (P>0.05). CONCLUSIONS: The new digital fibula transfer and fixation plate has good guiding surgical function in mandibular reconstruction, which can accurately resect the pathological bone segment during operation and ensure the position of the residual bone, the condyle, and the occlusion relationship. It can also reduce the operation time and reduce the ischemia time of the flap.

Key words: Fibular transfer fixation guide plate, Fibula musculocutaneous flap, Mandibular defect, Digital design

中图分类号:

R782.2

杨一帆, 张一博, 刘雪, 许立明, 孜尔达·阿依丁, 凌彬. 新型数字化腓骨转移固定导板在下颌骨缺损重建术中的应用[J]. 中国口腔颌面外科杂志, 2025, 23(1): 40-47.

YANG Yi-fan, ZHANG Yi-bo, LIU Xue, XU Li-ming, ZIERDA Ayiding, LING Bin. Application of a new digital fibular transfer and fixation guide plate in the reconstruction of mandibular defects[J]. China J Oral Maxillofac Surg, 2025, 23(1): 40-47.

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