下颌骨髁突骨折手术治疗失败原因及防治分析——附13例病例报告  

Analysis on Complications and Prophylaxis of Mandibular Condylar Fractures Surgical Treatments:A Report of 13 Cases

作　　者：刘慧[1] 胡露露[1] 王岳森[1] 陈青立[1] 方昌 帕热克江.帕塔尔 龚忠诚[1] LIU Hui;HU Lu-lu;WANG Yue - sen;CHEN Qing - li;FANG Chang;Parukejiang · Pataer;GONG Zhong-cheng(Department of Oral and Maxillofacial Oncological Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Chin)

机构地区：[1]新疆医科大学第一附属医院颌面肿瘤外科,新疆乌鲁木齐830054

出　　处：《口腔医学研究》2018年第3期278-281,共4页Journal of Oral Science Research

基　　金：国家自然科学基金(编号:81460439)

摘　　要：目的:分析髁突骨折术后严重并发症的原因及特点,探讨髁突骨折手术治疗失败的防治措施。方法:收集2012年1月~2017年11月新疆医科大学第一附属医院颌面外科收治手术失败的13例髁突骨折病例,评价骨折愈合情况及并发症,分析并总结治疗失败的原因及防治措施。结果:13例患者中,感染2例,咬合关系紊乱5例,螺钉松动4枚,钛板断裂1例,张口受限9例,面部不对称下颌偏斜3例。髁突骨折坚强内固定术的失败与术前评估不足、钛板放置位置欠佳、应力集中、术后功能锻炼不足及患者依从性差有关。结论:髁突骨折严重并发症可导致手术失败,掌握髁突骨折治疗的原则和正确方法非常重要。Objective：To analyze the reasons and the characteristics of postoperative severe complications for the failure treatment of condylar fracture,and to investigate the causes and appropriate precautionary methods for the condylar fracture surgical treatment.Methods：A total of 13 cases were collected,from January 2012 to November 2017 in the First Affiliated Hospital of Xinjiang Medical University,and the reasons for complications and treatments were analyzed.Results：In these cases,there were 2 cases with postoperative infection,5 cases with occlusion disorders,4 cases with screws loosen,1 case with plate broken,9 cases with limitation of mouth opening,and 3 cases with facial asymmetrical deformity.The main reasons for the failure of treatment included：（1）insufficient preoperative evaluation;（2）improper internal fixation materials,methods and sites,inappropriate stress concentration;（3）rejection of short-term intermaxillary fixation;（4）the poor compliance of patients.Conclusion：It is important to master the principle and right methods of condylar fracture treatment.

关 键 词：髁突骨折 术后失败 术后并发症 防治措施 

分 类 号：R782.4[医药卫生—口腔医学]