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s of post-operative infections despite the high proportion of alcohol abusers treated. There was also evidence to support JOHANSSON et al. who showed an effectiveness of miniplate osteosynthesis in treating mandibular fractures that were initially infected.
Reported disadvantages include the necessity for hospital admission, general anaesthesia, increased operating time and greater cost of materials. JOHANSSON stated that it is possible to perform miniplate osteosynthesis with local anaesthesia alone and thus reduce hospitalisation time. In the current study 4 patients were treated in this manner, with 2 managed on an out-patient basis. Following admission, in-patient time was generally found to be brief, 3 days being the most common. In no case was an extended period of hospitalisation related to the mandibular fracture or its treatment. The cost efficiency of plating versus traditional techniques is also an important issue. The time in the majority of cases varied between l and 2 h, which is only slightly longer than usually required for closed reduction techniques. However, the majority of patients do not require post-operative intermaxillary fixation, therefore intensive-care nursing is not required in the immediate recovery period. TAYLOR et al. have quantified the average cost of managing a fractured mandible with miniplate osteosynthesis and found that it is approximately 25% less than for treating a fracture with intermaxillary fixation.
Some authors have raised doubts as to the functional stability of Champy plates. This study, which demonstrated low levels of complications and occlusal problems does not support these fears. OIKARINEN et al. Is have suggested that miniplate osteosynthesis is a complicated technique unsuitable for a small treatment unit. This is contrary to the experience in our own unit where approximately one third of the cases were treated by junior registrars. The intra-oral approach, which avoids skin scars, and the easy manipulation of the plates contribute to the suitability of this technique for a teaching unit. Subsequent removal of miniplate is also a simple procedure requiring only local anaesthesia. However, the necessity of routime plate removal after healing is yet to be resolved. Although theoretical indications may exists, there is little clinical or experimental evidence yet available to indicate any risk associated with the long-term retention of titanium or stainless steel plates. In this series the plates have been removed in 29% of cases, prodominantly for research purposes. No local or systemic adverse effects from the retention of the
plates have been noted thus far.
Acknowledgements. We would like to thank Sydney Hospital, the United Dental Hospital and the staff of the medical records department for their assistance in gathering the data for this study. We also extend our thanks to Dr Russell Vickers for his technical advice.
l. osteosynthesis 骨整合
2. miniplate 小钢板
3. assault 斗殴
4. prophylactic 预防性的
5. metronidazole 甲哨唑
6. chlorhexidine 洗必太
7. epileptic fit 癫痫发作
8. spontaneous 自发性的
9. iatrogenic 医源性的
10. vagrant 流浪者
11. assanlaut 攻击者
12. vertebrae 脊椎
13. condylar 髁的
14. dehiscence 裂开
15. trismus 牙关紧闭
16. hospitaliation 住院