下颌骨伸、缩、升支骨折的外科矫正

George C. Hensel M.D., F.A.C.S.
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引用次数: 21

摘要

下颌骨矫正手术应满足一定的力学和功能要求,这些要求涉及三个基本考虑因素:1。解剖学上的恢复和骨骼整体的对称颞下颌关节的正确功能位置。牙齿咬合的维持或恢复讨论并说明了所涉及的原理。从技术难点和优势的角度对前颌和小颌手术的历史和现状进行了界定和分析。通过直接手术入路横断升支是首选的方法。目前使用的盲目操作方法存在一些严重的缺陷,远远达不到理想的最终效果。讨论并说明了下颌骨转位的外科和力学要求。在每一个病例中,上行支截骨的指定位置和方向都是明确的。截骨术的位置应保持在三/十六英寸的中心区域内。截骨的方向应根据下颌骨畸形的角度和质量以及牙弓关系不良的类型来确定。直接手术入路是满足这些要求的唯一方法。提出一种矫正下颌骨伸缩畸形的手术方法。它包括直接手术入路,允许在适当的方向和适合横断垂直支的区域进行可见的截骨。描述并举例说明了性能的方法。本文描述并说明了一种辅助手术来完成小畸形的美容矫正。本文讨论了为矫正前突和小突而设计的手术入路在某些升支骨折的植骨中的应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The surgical correction of mandibular protraction, retraction, and fractures of the ascending rami

Corrective surgery of the mandible should fulfill certain definite mechanical and functional requirements that deal with three essential considerations:

  • 1.

    Anatomic restoration and symmetry of this bone as a whole.

  • 2.

    Proper functional position of the temporomandibular joints.

  • 3.

    The maintenance or restoration of proper dental occlusion.

The principles involved are discussed and illustrated. The history and present position of surgery applied to prognathism and micrognathism are defined and analyzed from the standpoints of technical objections and advantages.

Transection of the ascending rami through a direct surgical approach is advocated as the method of choice. The blind method of performing this operation in current use has some serious objections and falls far short of achieving a proper end-result. The surgical and mechanical requirements of transposition of the mandible are discussed and illustrated. A prescribed position and direction of osteotomy of the ascending rami is indicated in every case. The position of osteotomy should be constant within a central area of three-sixteenths of an inch. The direction of osteotomy should be predetermined by the angle and mass of mandibular deformity and by the type of malrelationship of the dental arches. A direct surgical approach offers the only means of meeting these requirements.

An operative procedure for the correction of mandibular protraction and retraction is presented. It consists of a direct surgical approach that permits visible osteotomy in the proper direction and in the area suitable for transection of the vertical rami. The method of performance is described and illustrated.

A supplementary operation to complete the cosmetic correction of microgenia is described and illustrated.

The application of the surgical approach devised for the correction of prognathism and microgenia to osteosynthesis of certain fractures of the ascending rami is discussed.

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