解剖复位和游离复位治疗髁突骨折的实验研究  

Experimental Study on Anatomic Reduction of Lateral Pterygoid Muscle and Condylar Free Reduction for Condylar Fracture

作　　者：王金鹏 杨国军[1] 黎昌学[1] 陈筱雪 朱慧 赵格 Wang Jinpeng;Yang Guojun;Li Changxue(Department of Stomatology,The First Affiliated Hospital,Shihezi University School of Medicine,Xinjiang 832008,China)

机构地区：[1]石河子大学医学院第一附属医院口腔科,832000

出　　处：《医学研究杂志》2020年第7期131-135,共5页Journal of Medical Research

基　　金：石河子大学医学院第一附属医院重点基金资助项目(ZD201704)。

摘　　要：目的比较髁突骨折后翼外肌解剖复位与髁突游离复位的骨折愈合情况。方法24只新西兰兔随机分为两组,建立下颌骨髁颈骨折模型,一组行髁突游离复位,另一组行翼外肌解剖复位。术后2、4、6、8周动物颈部血管灌注墨汁后处死,测量两侧髁突前后径、内外径。术侧髁突切片、HE染色后观察分析髁突增殖层、微血管数目及骨参数的变化。结果术侧与健侧比较,髁突游离复位组髁突内外径4、6、8周术侧减小(P<0.05),翼外肌解剖复位组各时间点比较,差异无统计学意义(P>0.05);两侧髁突前后径比较,差异无统计学意义(P>0.05)。微血管数目比较髁突游离复位组各时间点均少于翼外肌解剖复位组(P<0.05)。除2周时Tb.N外,两组其余骨参数比较,差异均有统计学意义(P<0.05)。结论临床中保留翼外肌对骨折愈合和功能恢复具有重要意义。Objective To compare the fracture healing of keep lateral pterygoid muscle anatomic reduction with condylar free reduction in the treatment of condylar fractures.Methods Twenty-four New Zealand rabbits were randomly divided into two group to mandibular condylar neck fracture model was established.one team keep the lateral pterygoid muscle,the other excise it.Cervical vascular perfusion was done with ink before animals executed after operation 2,4,6 and 8 weeks.Bilateral anteroposterior and mediolateral condylar diameters measured.Changes of operation side condylar proliferating layer,microvessel number and bone parameters were observed and analyzed after slices and HE staining.Results The mediolateral condylar diameters of operation side were significantly smaller than health side in condylar free reduction group at the 4,6,8 weeks(P<0.05),but there was no statistical difference in the anteroposterior condylar diameters at each time point(P>0.05).There were no significant differences in the anteroposterior and mediolateral condylar diameters of the anatomic reduction lateral pterygoid muscle group compared between the operation side and health side(P>0.05).The number of microvessel in condylar free reduction group were smaller than those in anatomic reduction lateral pterygoid muscle group(P<0.05).There were significant differences in BV/TV,Tb.Th,Tb.Sp between the condylar free reduction group and the anatomic reduction lateral pterygoid muscle group(all P<0.05),and the Tb.N were significantly differences between two groups at the 4,6,8 weeks(P<0.05).Conclusion When the condyle is fractured it should keep lateral pterygoid muscle as possible,which is important in the fracture healing and functional recovering of mandibular.

关 键 词：髁突骨折 髁突-翼外肌解剖复位 髁状突游离复位 血供重建 骨折愈合 

分 类 号：R78[医药卫生—口腔医学]