SU1694131A1 - Method for treating infected fractures of the mandible - Google Patents

Abstract

The invention relates to dental surgery and can be used in the treatment of mandibular fractures. The method of treating infected mandible fractures consists of: - positioning bone fragments, fixing them with needles and ligatures, fractional administration of drugs, electrophoresis and electrostimulation, while in order to prevent the development of traumatic osteomyelitis, electrophoresis and electrostimulation are performed simultaneously in one mode . 2 Il.

Description

The invention relates to dental surgery and can be used in the treatment of mandibular fractures.

The aim of the invention is to prevent the development of traumatic osteomyelitis.

Figure 1 shows the device, a general view; figure 2 is the same, top view.

The device consists of two ligatures 1 and 2, twisted into loops. Through which the fixing needle 3 is threaded, is located on the inner surface of the lower jaw on both sides of the fracture area. The needle 3 is made in the form of a thin steel tube with a seal of the end face that is mated with a portion of the tube that has a longitudinal one- or two-sided perforation and is installed in the fracture zone.

The method of treatment of infected mandible fractures is carried out as follows.

After exposing the outer and inner surfaces of the lower jaw with an external incision and removing loose small bone fragments, reposition of the bone fragments 4 and 5 is performed under the control of the occlusion, and then one through diverging hole is drilled on each skew, dark fragment. For osteosynthesis, segments of bioinert ligatures 1 and 2 are used, which are conducted through artificially created bone channels in such a way that two loops form on the inner surface of the mandible and two free ends on the outer surface of the mandible. Thereafter, through a puncture of the skin in the mandibular region, a locking needle 3 is inserted, which is held through the loops of the ligatures 1 and 2 so that its perforated area is above the fracture line. The two free ends of the ligatures are then twisted or bound, thus pressing the needle to the inner surface of the mandible. As a result of this, the bone fragments 4 and 5 are rigidly fixed in the desired position. The twisted ends of the ligatures 1 and 2 are directly under the skin. To eliminate the blockage of the internal channel of the spokes, before it is inserted, a metal mandrel is inserted, the diameter of which coincides: with the internal diameter of the channel of the spokes. During therapeutic manipulations, vacuum drainage, dialysis, electrophoresis) mandrins are removed from the spokes. 1 Vacuum drainage (connecting to a vacuum source) is carried out through the cannula, the internal canal and the lateral longitudinal perforation of the needle 3, drugs are fractionally injected directly into the fracture zone (using a Record syringe or through a disposable system for blood transfusion). At the same time, when approaching the needle 3 and the external cutaneous passive electrode b of the potential, intra-wound electrophoresis is carried out, which makes it possible to achieve a high selective concentration of drugs directly in the fracture zone. Supply of potential allows simultaneous electrophoresis to conduct electrostimulation in one mode. The outer passive electrode is made of a silvered plate of 3.0 2.0 with a hydrophilic pad. The polarity of exposure is determined by the active ion of the drug, the duration of the procedure is 1 hour, daily for 10-18 days. Current strength 15-30 uA. An increase in current strength of more than 30 µA irritates the tissue in the wound, the effect of less than 15 µA reduces the effectiveness of intra-electrophoresis and electrostimulation. After the procedure, sterile metal mandrin is re-inserted into the needle.

Example. Ill B., 22 years old, was admitted to the clinic 24.03.89 with a diagnosis of fracture

mandible in the left corner, complicated by phlegmon of the submandibular region, left for a day after a household injury. According to X-ray data, debris displacement of more than 1 cm. On the 1 st day, a general anesthesia was performed. Opening the cellulitis of the submandibular region on the left, osteosynthesis of the lower jaw using a modified fixator. Within 5

days after surgery, vacuum drainage and fractional dialysis of 0.2% chlorhexidine, 0.5% dioxidine were performed, 600 mg of lincomycin were injected. After cessation of exudation from the wound, intraday electrophoresis with 5% dimexide solution was started for one day and electrically stimulated at one time with a current strength of 20-25 μA. Healing is smooth. After three electrophoresis procedures with electrostimulation, the volume blood flow in the damage zone according to rheography increased from 0.13 to 0.25%, and by the tenth procedure it was 0.41%

The locking needles and ligature removed 4 weeks after the operation, the movement of the mandible in full. Micro mobility fragments not.

Thus, the proposed method provides a warning for the development of

traumatic osteomyelitis and reduces the frequency of inflammatory complications and stimulation of reparative osteogenesis.

Claims (1)

Invention Formula The method of treatment of infected mandible fractures, consisting in reposition of bone fragments, their fixation with the help of needles and ligatures, fractional administration of drugs, electrophoresis and electrostimulation, characterized in that, in order to prevent the development of traumatic osteomyelitis, electrophoresis and electrostimulation held simultaneously in one 5 mode Fig 2 1