儿童髁突囊内骨折外脱位合并颏部骨折的治疗:附1例报告  

Treatment of bilateral intracapsular condylar fracture displaced superolaterally with symphysis fracture in children: report of 1 case

作　　者：蔡怡华[1] 陆川[1] 何冬梅[1] 杨驰[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔外科,上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2014年第3期281-284,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市科学技术委员会资助项目(08DZ2271100;13XD1402300);上海高校创新团队发展计划;教育部留学回国人员科研启动基金;卫生行业公益基金(201002017)~~

摘　　要：儿童髁突囊内骨折常见,若治疗不当会引起后遗症。本文报告1例儿童双侧髁突骨折外上脱位伴颏部骨折,外院颏部骨折固定术后咬合紊乱。重新手术,颏部骨折复位固定,恢复牙弓宽度,关闭舌侧裂隙。手法复位双侧外脱位的髁突,使其进入关节窝内。采用改良牙弓夹板进行颌间结扎牵引,改善咬合关系。术后随访显示,髁突位于关节窝内、双侧髁突和关节窝均愈合改建,咬合关系良好。该病例提示,儿童双侧髁突囊内骨折外上脱位伴颏部骨折治疗的关键在于恢复牙弓宽度,纠正外脱位的髁突。Intracapsular condylar fracture is common in children. If treated improperly, complications will occur. We presented a case of a child who had bilateral intracapsular condylar fracture displaced superolaterally with symphysis fracture, manifesting malocclusion after symphysis fixation at local hospital. The symphysis fracture was refixed to correct the widening of the mandible arch by open reduction and the position of bilateral condyle in the TMJ fossa was corrected by reduction with hands. Intermaxillary fixation especially for children was applied to improve the occlusion. After 3 months of follow-up, CT showed that bilateral condyle was in the right position of the TMJ fossa, bilateral condyle and TMJ fossa remodeled and favorable occlusion was achieved. This case illustrated the principle of bilateral intracapsular condylar fracture displaced superolaterally with symphysis fracture in children is to correct the widening of mandible arch and the condylar displaced superolaterally. Supported by Research Fund of Science and Technology Committee of Shanghai Municipality（08DZ2271100,13XD1402300）, Program for Innovative Research Team of Shanghai Municipal Education Commission, Scientific Research Foundation of Ministry of Education for Returned Overseas Scholars, and Research Fund of the Ministry of Health of China（201002017）.

关 键 词：儿童 髁突囊内骨折 颏部骨折 

分 类 号：R782.6[医药卫生—口腔医学]