下颌骨髁突不同类型骨折钛板内固定手术治疗相关影响因素分析  

Analysis of Related Factors of Fixed Operation Treatment with Titanium Plate in Different Types of Fracture of Mandibular Condyle

作　　者：金宝忠[1] 肖进[1] 胡孙强 徐伟[1] 李祖兵[2] 

机构地区：[1]温州医科大学附属口腔医院口腔颌面外科,浙江温州325027 [2]武汉大学口腔医学院口腔颌面外科

出　　处：《口腔医学研究》2014年第8期773-776,共4页Journal of Oral Science Research

摘　　要：目的：分析下颌骨髁突不同类型骨折进行钛板内固定手术及其影响术后并发症的相关因素,为以后下颌骨髁突骨折治疗总结经验以便更好的为患者服务。方法：收集温州医科大学附属口腔医院2003年4月~2012年4月手术完成的下颌骨髁突骨折行钛板内固定患者,手术前后复查对比下颌骨全景片、下颌骨平扫CT、下颌骨矢状CT及颅颌三维CT重建。依据下颌骨骨折部位分为髁突囊内骨折,髁突颈部骨折,髁突基部骨折3组,对3组骨折术后患者的咬合状况、开口度、面神经功能等恢复情况进行回顾性分析。结果：210例随访病例中,术后咬合关系恢复不良30例;螺钉松动57枚,钛板断裂0例,面神经颧支损伤15例,面神经颞支损伤30例,张口受限伴下颌运动曲线患侧偏斜35例。结论：解剖手术能力或者面神经的个体变异;创口感染;不适当的应力集中、钛板和螺钉的位置、数量及固定部位,颌间牵引,关节周围相关软组织复位状况等为影响下颌骨髁突骨折坚强内固定手术并发症相关因素。Objective： To analyne of related factors of fixed operation treatment with titanium plate in different types of fracture of mandibular condyle. Methods： Cases of Oral Hospital of Wenzhou Medical University from April 2003 to April 2012 were collected. We comparative reviewed before and after operation the mandible panoramic x-ray, CT scan of mandible , mandibular sagittal CT and craniofacial 3D CT reconstruction, On the basis of the mandibular fracture site the cases were divided into 3 groups： intracapsular condylar fracture3 condylar neck fractures;base of condylar fracture. Results： In the 210 follow-up cases malocclusion 303screws loose 573 titanium plates break 03 zygomatic branch of facial nerves injury 153 temporal branch of nerves injury 3031imitation of mouth opening and mandibular movement curve deviation 35. Conclusion： Anatomical operation ability, individual variation of facial nerve, infection, undue stress concentration, the position and number of titanium plates and titanium nails, the intermaxillary traction, periarticular soft tissues are factors related to operation complications.

关 键 词：下颌骨髁突骨折 坚强内固定 面神经损伤 张口受限及咬合偏斜 手术并发症 

分 类 号：R782.4[医药卫生—口腔医学]