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脱位性髁突矢状骨折手术治疗的近期疗效观察 被引量:8

Surgical Treatment of Dislocation Sagittal Fracture of the Mandibular Condyle
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摘要 目的总结脱位性髁突矢状骨折(DSFMC)的手术治疗经验。方法将22例28侧DSFMC分型,总结各类型DSFMC的手术治疗方法,并对术前及术后6个月患者的咬合关系、最大张口度、张口偏斜、髁突术后形态等进行观察比较。结果①DSFMC以Ⅱ型骨折最多,占57%;其次为Ⅲ型骨折和Ⅰ型骨折,分别占25%和18%。②5侧Ⅰ型骨折均行骨折片摘除术;16侧Ⅱ型骨折中,9侧行骨折片游离再植加微型接骨板坚固内固定术,5侧行骨折片摘除,2侧切除髁突;Ⅲ型骨折中有5侧行骨折片游离再植加微型接骨板坚固内固定术,2侧行摘除骨碎片,修整髁突残端。③22例患者术后6个月平均张口度为33.9 mm,平均张口偏斜1.5 mm,均比术前明显改善(P<0.05)。术后6个月咬合关系完全恢复正常17例,5例术后仍有1 ̄2 mm的前牙开!,经调!后,咬合关系恢复良好。④术后再植髁突未见明显吸收,微型接骨板无明显变形。结论DSFMC手术治疗可以取得较好的效果,张口度、张口型均较术前明显改善,咬合关系恢复良好,再植髁突无明显吸收。 Objective To summarize the surgical treatment effects of dislocation sagittal fracture of the mandibular condyle (DSFMC). Methods Twenty-two cases of DSFMC were classified according to the fracture location and treated with surgery. The clinical and radiographic outcomes were contrasted before and after treatment. Results ① There were 18%, 57% and 25% cases of type Ⅰ, type Ⅱ and type Ⅲ DSFMC respectively.②For type Ⅰ DSFMC, dislocation part of condyle was removed. For type Ⅱ DSFMC, nine dislocation parts of condyles were free grafting and rigid fixation, and five dislocation parts of condyles were removed. The whole condyle was resected because of ankylosis of TMJ in two cases. For type Ⅲ DSFMC, dislocation part was free grafting and rigid fixation in five condyles. The whole condyle was removed in two cases due to comminuted DSFMC. ③Postoperative mouth opening and mouth opening deviation were 33.9 mm and 1.5 mm respectively 6 months after the surgical treatment. There were significant improvement on mouth opening and mouth opening deviation than those before the surgical treatment(P〈0.05). Normal occluding relation was resumed in 17 cases. With occlusal adjustment, occluding relation was resumed also for those 5 cases that showed 1-2 mm open bite. ④There was no postoperative evidence of condylar resorption and plate distortion. Conclusion Surgical treatment is an effective way for DSFMC. Mouth opening and mouth opening deviation can be improved significantly after surgical treatment. After surgical treatment, DSFMC can resume normal occlusal relation also. There is no significant condylar resorption after free grafting.
出处 《华西口腔医学杂志》 CAS CSCD 北大核心 2007年第1期58-60,共3页 West China Journal of Stomatology
基金 宁夏回族自治区卫生厅重点科研计划课题资助项目(W200648)
关键词 下颌骨髁突 矢状骨折 游离再植 坚固内固定 mandibular condyle sagittal fracture free grafting rigid fixation
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