髁突矢状骨折继发颞下颌关节强直31例临床分析  

Clinical Analysis of 31 Cases of Temporomandibular Joint Ankylosis Secondary to Condylar Sagittal Fractures

作　　者：向国林[1] 邓末宏[2] 李威[2] 王琳琳[1] 任雯[1] 韩前超[1] 龙星[2] 

机构地区：[1]华中科技大学同济医学院附属普爱医院口腔科,湖北武汉430033 [2]武汉大学口腔医学院口腔颌面外科,湖北武汉430079

出　　处：《口腔医学研究》2016年第11期1179-1182,共4页Journal of Oral Science Research

基　　金：武汉市卫生计生委临床医学科研项目(编号:WX12D19;WX16D23)

摘　　要：目的：探讨髁突矢状骨折继发创伤性颞下颌关节强直的临床特点。方法：回顾性分析2001-2010年武汉大学口腔医院口腔颌面外科收治的31例、48侧继发于髁突矢状骨折的颞下颌关节强直患者的相关临床资料。结果：31例颞下颌关节强直患者平均外伤年龄15.6岁,其中23例（74.2%）外伤年龄小于16岁。病程3月-20年,平均病程6.5年。42侧强直关节的关节盘发生移位,6侧强直关节的关节盘完全破坏。强直关节标本镜下观察：内侧髁突骨折块发生废用萎缩性改变,外侧骨球区见软骨细胞呈灶性增生成骨,关节盘纤维结构紊乱、玻璃样变性。结论：青少年髁突矢状骨折易发生颞下颌关节强直,关节盘的移位损伤是颞下颌关节强直发生的重要条件。创伤性颞下颌关节强直首先发生在关节外侧,融合骨赘的组织病理学表现为软骨化生、成骨。Objective：To explore the clinical characteristics of traumatic temporomandibular joint ankylosis（TMJA）secondary to condylar sagittal fractures.Methods：Thirty-one patients with a total number of 48 ankylosed temporomandibular joints secondary to condylar sagittal fractures,in the Hospital of Stomatology,Wuhan University during the period of 2001-2010,were retrospectively reviewed.Results：The mean age of patients at injury was15.6years old,and 23patients（74.2%）was less than 16 years old.The time interval between initial injury and presentation of TMJA varied from 3 months to 20 years,with a mean disease course of 6.5years.The articular discs were observed displaced or disrupted in all 48 ankylosed joints.Histopathology of ankylosed joint revealed that the medially displaced condylar fragments showed the changes of disusatrophy,while cartilaginous metaplasia and ossification were found in the lateral osseous fusions and hyaline degeneration was observed in the disrupted articular discs.Conclusion：Traumatic TMJA secondary to condylar sagittal fractures usually occurred in the adolescents.The damaged articular disc should be account for the development of TMJA.Furthermore,the osseous fusions were initially originated from the lateral of joint surface.Chondrification and endochondral ossification were responsible for the formation of osseous fusions.

关 键 词：髁突骨折 颞下颌关节 关节强直 

分 类 号：R782.61[医药卫生—口腔医学]