改良入路复位内固定治疗髁突骨折的疗效  

Clinical effects of modified approach for condylar and subcondylar fractures

作　　者：薛桂平[1] 叶钟泰[2] 魏红宇[1] 许辉[2] 多力昆.吾甫尔 木合塔尔.霍加 

机构地区：[1]上海同济大学附属同济医院颌面外科,200065 [2]新疆维吾尔自治区人民医院附属口腔医院颌面外科

出　　处：《实用口腔医学杂志》2009年第5期685-688,共4页Journal of Practical Stomatology

摘　　要：目的：介绍一种改良的腮腺切口入路治疗髁突骨折的手术方法并作疗效分析。方法：通过类“S”腮腺切口,经改良的腮腺入路,直达髁突骨折处,对髁颈和髁颈下骨折27例34侧行小型钛板坚强内固定术,术后3月～5年复查,包括拍摄全景片,记录张口度,开口型,咬合关系,外伤前后咬合力的改变,面神经损伤情况。结果：1例1侧钛板断裂,2例2侧骨折未完全复位;6例7侧出现面神经损伤症状,其中,2例2侧部分恢复,4例5侧完全恢复。2例张口受限,轻度咬合痛,3例关节弹响。结论：改良的腮腺入路法治疗髁突骨折,手术创伤小,操作简单,能达到髁突骨折解剖复位,钛板坚强内固定的要求。Objective：To introduce a modified introparotid gland approach to treat condylar fractures.Methods：Twenty-seven condylar neck and subcondylar fractures were involved.The fractures were approached by modified introparotid incision and miniplate rigid fixation methods.Postoperative follow-up was 3 months to 5 years.The treatment results were evaluated by occlusion,joint function,facial nerve damage as well as radiographic assessment of condylar changes.Results：There were 1 patient with plate fracture,2 patients with inadequate reduction,6 patients with facial nerve damage,2 patients with limited mouth opening,and 3 patients with temporo-mandibular joint disease.There were 2 incomplete recoveries and 4 complete recoveries in these 6 facial nerve palsies.Conclusion：Miniplate rigid fixation combined with modified introparotid gland approach to treat condylar fractures is effective to treat condyle and subcondylar fractures.

关 键 词：髁突骨折 类“S”腮腺切口 坚强内固定 

分 类 号：R782.4[医药卫生—口腔医学]