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REHABILITATION OF PATIENTS WITH MULTIPLE AND COMBINED
FRACTURES OF FACIAL BONES
Mirzaev Abduqodir Rustamovich
Tashkent State Dental Institute
Annotation. Rehabilitation of patients with multiple and combined trauma of
facial bones with shape memory devices and endoprostheses made of porous
titanium nickelide allowed us to achieve good cosmetic, anatomical and functional
results in 96% of patients. The peculiarities of facial bone architectonics also
require differently shaped fixators and endoprostheses depending on the
localization and types of fracture. The methods of treatment of fractures and
elimination of defects and deformities of facial skull bones developed by us for the
first time in the world can serve as the methods of choice.
Key words: osteosynthesis, shape memory devices and fixators, porous
titanium nickelide endoprostheses.
Purpose of the study:
general analysis of the rehabilitation period of patients
with multiple and combined fractures of facial bones.
Material and methods of research:
The study of materials of the clinic of
maxillofacial surgery of the Tashkent State Dental Institute for the last 5 years
showed that multiple and combined injuries make up 32.6% of the total number of
facial bone injuries. Under our observation there were 876 patients aged from 15
to 69 years, and 33 of them had defects and deformations. The great achievement
in maxillofacial traumatology was the portable devices and fixators with
predetermined properties of different shapes depending on localization and types
of fracture developed by us for the first time in the world; they are protected by
copyright certificates and patents. Porous titanium nickelide in the form of disks
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0.2-0.5 mm thick for the manufacture of endoprostheses for the elimination of bone
defects of the middle zone of the face, which are easily modeled on the operating
table, as well as porous plates with a thickness of 4 mm for the elimination of
defects of the lower jaw.
RESULTS:
In the clinic in cases of combined craniofacial injuries with
craniocerebral trauma (concussion or cerebral contusion), surgical intervention was
performed mainly within the first two days. Patients with fractures of the lower
jaw, zygolabial complex, then with sub-basal and suborbital injuries, as well as
with fractures of the alveolar process of the maxilla of various localizations
prevailed. Multiple fractures of facial bones belong to the category of severe
injuries. The severity of the condition of the victims is determined by the amount
of damage to the bony structures of the facial skeleton. The tactics of treatment of
multiple facial injuries is the sequence and continuity of therapeutic measures. The
first stage was the intervention on the lower jaw, and the second stage was
osteosynthesis on the middle zone of the face, giving great importance to the
restoration of dental occlusion of the jaws. This approach allows us to exclude
intermaxillary fixation from the treatment measures in most cases, which is
important for victims with craniocerebral trauma with impaired external respiratory
function. We attached great importance to stable osteosynthesis with shape
memory devices.
Conclusions:
Thus, in fractures of the mandibular div within the dentition
and angle, we used both extraoral and intraoral access, in fractures of the branch
and condyle - extraoral access without additional immobilization. For multiple
fractures, an example is a patient with industrial trauma: chin detachment, fracture
of the condyles, dislocation of the heads, fracture of the alveolar processes of the
upper jaws - osteosynthesis with shape memory devices without additional
immobilization was performed.
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