双长螺钉在下颌骨髁突骨折坚固内固定中的应用  

Application of Double Long Screws in the Internal Fixation of Mandibular Condylar Fracture

作　　者：龚忠诚[1,2,3] 克热木.阿巴斯 凌彬[1,2,3] 刘慧[1,2,3] 尹小朋[1,2,3] 邵博[1,2,3] 林兆全[1,2,3] 

机构地区：[1]新疆医科大学第一附属医院颌面肿瘤外科 [2]新疆医科大学口腔医学系 [3]新疆维吾尔自治区口腔医学研究所,新疆乌鲁木齐830054

出　　处：《口腔医学研究》2013年第1期58-60,共3页Journal of Oral Science Research

基　　金：新疆维吾尔自治区自然基金(编号:2011211A068)

摘　　要：目的:探讨双长螺钉在下颌骨髁突骨折坚固内固定中的应用。方法:2007年7月～2011年12月我科收治的下颌骨髁突斜行或矢状骨折患者27例(30侧),年龄15～57岁,男性19例,女性8例。采用耳前直线切口入路,髁突复位后,用2枚18mm长2mm直径的钛钉固定断离的髁突。术后复查三维CT了解复位情况,评估术后开口度、颞下颌关节运动、咀嚼功能、咬合情况及面部外形等。结果:完全解剖复位固定的25侧髁突;5侧髁突固定良好,但髁突与下颌升支成角,角度均在15°以内;所有患者的咬合关系均恢复到受伤前状态;术后3m均能进普通饮食,开口度为(35.8±4.2)mm;4例患者术后自觉手术侧颞下颌关节运动时有摩擦音,3例患者术后2m仍觉关节区轻度疼痛;瘢痕隐蔽美观。结论:双长螺钉固定下颌骨髁突斜形或矢状骨折效果肯定。Objective： To explore the application of double long screws in the internal fixation of mandibular condylar fracture. Methods： Twenty seven cases （19 males and 8 females） with 30 mandibular condylar fractures were performed the internal fixation using two long screws respectively. All the condylar fractures were oblique or sagittal. Pre-auricular incision was applied to approach the fractured condyle, and the fractured bone was fixed by two long screws with 18 mm length and 2 mm diameter. The three dimensional CT were used to evaluate the results of reduction and fixation of the fractured condyles. The width of mouth opening, movement of temporomandibular joint, occlusion and facial symmetry were analyzed. Results： All patients had symmetrical face, normal mastication and rigid fixed condyles. Mouth opening increased from （22.3 ± 7.5） mm （before surgery） to （35.8 ± 4. 2） mm （3m after surgery）. Twenty five fractured condyles were anatomically reduced. Three patients felt slightly pain in the affected joints in postoperative 2m, and 4 cases had nosing in the joints. Conclusion： It might be an applicable method to fix the fractured condyle （oblique or sagittal type） using two long screws.

关 键 词：下颌骨 髁突 骨折 内固定 长螺钉 

分 类 号：R782.4[医药卫生—口腔医学]