髁突游离回植术治疗移位髁突骨折的初步分析  

Free Condyle Replantation for the Treatment of Severe Displaced Condylar Fracture

作　　者：汪维健[1] 匡威[1] 王桥[1] 李洪涛[1] 施海鹏[1] 孙烁辉[1] 

机构地区：[1]广州军区广州总医院口腔科,广东广州510010

出　　处：《口腔颌面外科杂志》2010年第6期410-413,共4页Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(30900860)

摘　　要：目的:分析髁突游离回植术治疗重度移位髁突骨折的适应证、固定方法及疗效。方法:对43例、56侧严重移位的髁突骨折进行了移位角度、移位程度及翼外肌附丽情况测量,43例均施行髁突游离回植术,固定方法分别为钢丝骨间固定、小型钛板固定及横向拉力螺钉固定;观察时间6个月;采取临床标准(切口感染、开口度、咬合关系、中线偏移、面神经损伤、咀嚼疼痛等情况)和影像学检查评价治疗成功率、分析疗效,研究所选固定方法的优缺点。结果:髁突游离回植治疗重度移位的髁突骨折成功率高达98.2%;固定方法以小型钛板固定及横向拉力螺钉固定更加可靠、简捷,术后移位小,咬合关系好。56侧中仅有2侧有轻微的面神经损伤,2例咬合轻度错位。结论:髁突游离回植术治疗重度移位髁突骨折成功率高,疗效较佳,适用于有严重移位的髁突骨折。Objective：To investigate the indication,fixation and effects of free condyle replantation for the treatment of severe displaced condyle fracture.Methods：43 cases（56 fractures） were retrospectively analyzed.Displaced angulation, displaced severity and lateral pterygoid muscle attachment were measured All the 43 cases were treated with free condyle replantation and fixed by stainless steel wire,titanic micro-plates,or transverse lag screw.All the cases were followed up for 6 months.Clinical criteria including infection of incision,width of mouth-opening,occlusion,midline discrepancy, injury of facial nerve,masticatory pain and imaging test were examined to evaluate the success rate,treatment effects and advantages and disadvantages of different fixation methods.Results：The success rate of free condyle replantation for the treatment of severe displaced condylar fracture was 98.2%.Titanic micro-plates and transverse lag screw fixation were much more reliable with less displacement and better occlusion.Only one slight facial nerve injury and 2 malocclusion cases were observed.Conclusion：Free condyle replantation sheds light on severe displaced condyle fracture with high success rate and favourable prognosis.

关 键 词：髁突游离回植 重度移位 固定方法 疗效 

分 类 号：R782.4[医药卫生—口腔医学]