摘要
目的:探讨应用定量截骨锯,行口腔内入路髁突高位骨折手术治疗的效果。方法:对13例14侧下颌骨髁突颈骨折患者采用口腔内入路,用定量截骨锯将下颌骨升支后缘垂直截骨,取出升支后缘骨块,将骨折的髁突游离后取出,体外直视下将骨折片与升支后缘骨块复位固定后再从口腔内原切口回植,行颞下颌关节重建。结果:术后6、12、24月复查全部患者的开口范围25～40mm,平均为37.2mm。除1例患侧后牙早接触,下切牙中线偏斜1mm;另1例张口约25mm,轻度受限外,其余患者咬合关系良好,无其他并发症。结论:口腔内入路具有无外部皮肤瘢痕,且不损伤面神经的优点。但操作视野较小,增加了操作的难度。
Objective： To evaluate the effects of fixing and reduction of condyle neck fracture by an intraoral approach with the quantitation saw. Methods： Thirteen patients （14 condyles） were underwent open reduction and osteosynthesis with plates and screws, through intraoral approach. Vertical osteotomy of mandibular ramus was performed with a quantitation saw, and the posterior border bone block of mandibular ramus was taken out of the mouth, then the fractured neck of condyle was exposed and taken out after dissociation. The fractured neck of condyle and the posterior border bone block of mandibular ramus were reunion with an titanium miniplate in vitro. Then the reunioned condyle was reimplanted and repositioned in site. After occlusion adjustment, the condyle was reducted. A small titanium plate was used to secure the bone reunion. Results： Anatomic reduction was achieved in all patients without facial nerve or major auricular nerve damage, or salivary fistula. The range of mouth opening was 25-40 mm（37.2 mm average）,12 months postoperation. Ideal occlusion was gained in most patients except two. The posterior teeth of one case showed premature contact, and midline of mandibular teeth were askew. The mouth opening of another case were only 25 mm. Conclusion： The transoral approach proved to be a reliable surgical approach for reduction fractures of the neck of condyle. The disadvantage is hard to do vertical osteotomy of the mandibular ramus in such a small operation view.
出处
《口腔颌面外科杂志》
CAS
2007年第1期61-64,共4页
Journal of Oral and Maxillofacial Surgery
基金
首都医学发展科研基金项目(20023091)
国家自然科学基金(30471902)
关键词
口腔内人路
髁突骨折
重建术
下颌骨
intraoral approach
fracture of condyle
reduction
mandibular
