在下颌骨髁突骨折中运用长螺钉内固定的临床效果分析  

Clinical Study of Long Screw in Treatment of Mandibular Condylar Fracture

作　　者：徐家友[1] 

机构地区：[1]河南省商丘市第一人民医院口腔科,河南商丘476100

出　　处：《中国现代医生》2009年第2期22-23,25,共3页China Modern Doctor

摘　　要：目的评价长螺钉在下颌骨髁突骨折固定中的临床效果。方法对16例共21侧下颌骨髁突骨折患者进行开放手术,其中19侧应用长螺钉复位固定,2侧行骨折片摘除。收集术前术后及7例随访病人的临床及X线片资料,进行临床和影像学评价。结果19侧手术关节中,患者术后愈合良好,出院时开口度均大于3cm,X线片示复位固定良好,升支高度恢复。与健侧比较,术前患侧升支高度平均缩短为7mm,术后缩短不足2mm,两组统计学分析有显著性差异;术前前后向平均夹角为34度,术后为10度,两组统计学分析有显著性差异;术前内外侧向平均夹角为55度,术后为16度,两组统计学分析亦有显著性差异。7例随访病人(术后4～13个月,平均9个月)临床上,患者主观满意,平均开口度为39mm,开口型正常,前伸侧向运动均大于5mm,无关节弹响疼痛等关节功能障碍,无面神经受累等症状。影像学上,除1例双侧髁突骨折患者髁突中度吸收外,其余患者升支高度恢复,前后及内外向夹角均消失。结论长螺钉可用于髁突斜形骨折开放复位的内固定,特别是累及囊内的斜形矢状骨折的手术治疗,但其长期效果有待进一步随访观察。Objective To evaluate use of long screw in treatment of condylar process fractures. Methods Sixteen patients underwent surgery for mandibular condylar fractures via a preauricular approach. The repositioned fragments were fixed using long screws. Clinical and radiologic examinations were recorded postoperatively. Results The postoperative course was uneventful in most patients. The average shortening of ramus height preoperation was 7 mm, and that of immediate postoperation was less 2 mm. There was significant difference. The average angulation in the anteroposterior direction preoperation was 34 degree, and that of postoperation was 10 degree. There was significant difference. The average angulation mediolateral direction preoperation was 55 degree, and that of postoperation was 16 degree. There was also significant difference. Seven patients were followed up. All patients were satisfied with their operations, the average MMO was 39mm, there were no signs of deviation and TMD and other complications. All ramus height and angulation were normal except of one bilateral condylar fracture with moderate resorption. Conclusion Treatment of mandibular condylar fractures using longs crew is ideal in oblique condylar fracture, especial fracture related to intracapusule.The effect need further follow up.

关 键 词：上颌骨 髁突骨折 固定 螺钉 手术治疗 

分 类 号：R782.4[医药卫生—口腔医学]