髁突矢状骨折复位钳的研制及临床效果评价  

Development and clinical evaluation of a reduction forcep for mandibular condylar sagittal fracture

作　　者：彭国光[1] 杨磊[1] 王科[1] 谭玉莲[1] 

机构地区：[1]佛山市中医院口腔医疗中心,528000

出　　处：《中华创伤杂志》2014年第7期695-699,共5页Chinese Journal of Trauma

基　　金：广东省科学技术厅资助项目（2011A030300014）

摘　　要：目的 研制一种适合髁突矢状骨折（sagittal fracture of mandibular condyle,SFMC）骨碎块复位和内固定的复位钳,并评价其临床应用效果. 方法 对20例三维CT确诊的下颌骨SFMC患者行开放性手术治疗.按随机数字表法分为试验组和对照组,每组10例.试验组用研发的髁突复位钳进行手术复位和内固定;对照组用经典血管钳和神经拉钩行复位内固定手术.分别记录两组患者的手术时间、术前和术后2周三维CT、术前和术后1,6个月咬合情况、最大开口度（maximal mouth opening,MMO）、视觉模拟评分（visual analogue scale,VAS）、关节弹响和杂音.结果 试验组和对照组术时间分别为（0.90 ±0.11）h、（1.34±0.1O）h,试验组手术时间明显缩短（t=-10.8,P＜0.01）.试验组和对照组术后1,6个月MMO分别为[（32.6±1.6）mm∶ （29.7±1.6） mm]和[（34.3±1.2）mm∶（33.3±1.1）mm]（t=-10.1,3.4,P＜0.01）;试验组和对照组术后1,6个月VAS分别为[（3.6±0.7）∶（5.1±0.7）]和[（3.5±0.9）∶（4.8±0.6）]（t=-12.5,-3.3,P＜0.01）,试验组术后MMO和VAS明显改善. 结论 髁突复位钳可明显缩短SFMC的手术时间,改善开口功能和缓解疼痛.Objective To develop a suitable forcep for reduction and internal fixation of sagittal fracture of mandibular condyle （SFMC） and evaluate its role in clinical practice.Methods Twenty patients with SFMC diagnosed by three-dimensional CT undergone open surgery were divided into experimental group and control group with 10 patients per group,according to the random number table.Patients in experimental group were reduced and fixed using the new reduction forcep,while in control group by the classical vascular clamp and nerve retractor.Operation time,three-dimensional CT before operation and 2 weeks after operation,and occlusion,maximum mouth opening （MMO）,visual analogue scale （VAS）,joint clicking as well as noise before operation and 1 and 6 months after operation were recorded.Results Operation time was obviously lower in experimental group than in control group [（0.90 ± O.11）hours vs （1.34 ±0.10）hours,t =-10.8,P ＜0.01].MMO in experimental group revealed significant improvements compared to control group at postoperative 1 month [（32.6 ± 1.6） mm vs （29.7 ±1.6）mm,t =-10.1,P＜0.01] and at postoperative 6 months [（34.3 ± 1.2）mm vs （33.3 ± 1.1）mm,t =3.4,P ＜0.01].VAS between experimental group and control group also differed significantly at postoperative 1 month [（3.6 ± 0.7） mm vs （5.1 ± 0.7） mm,t =-12.5,P ＜ 0.01] and at 6 months [（3.5±0.9） points vs （4.8±0.6） points,t=-3.3,P＜0.01].Conclusion The new reduction forcep can shorten operative time and improve mouth opening and pai for SFMC.

关 键 词：骨折 下颌骨髁状突 口腔外科手术 

分 类 号：R782.4[医药卫生—口腔医学]