牵引复位固定术在髁突低位骨折患者中的应用  

Application of traction reduction and fixation in patients with low condylar fracture

作　　者：周小龙[1] 胡明 陈攀 李明军 和王刚 ZHOU Xiao-long;HU Ming;CHEN Pan;LI Ming-jun;HE Wang-gang(Department of Stomatology,Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市中医医院口腔科,陕西安康725000

出　　处：《海南医学》2023年第15期2168-2171,共4页Hainan Medical Journal

基　　金：陕西省重点研发计划项目(编号:S2020-YF-YBSF-0777)。

摘　　要：目的探讨牵引复位固定术在髁突低位骨折患者中的应用效果及对颞下颌关节紊乱指数(CMI)、颞下颌功能障碍指数(DI)、肌肉压痛指数(PI)的影响。方法选择2016年1月至2022年1月安康市中医医院收治的102例髁突低位骨折患者进行前瞻性研究,按照随机数表法分为观察组和对照组各51例。对照组患者接受坚固内固定术治疗,观察组患者在对照组基础上联合牵引复位固定术治疗。比较两组患者术后2周的临床疗效、围术期情况,以及术前、术后3个月的CMI、DI、PI和术后并发症发生情况。结果观察组患者的治疗总有效率为92.16%,明显高于对照组的76.47%,差异有统计学意义(P<0.05);观察组患者的手术时间为(67.23±6.83)min,明显长于对照组的(63.40±6.23)min,住院时间为(8.62±1.18)d,明显短于对照组的(9.30±1.05)d,差异均有统计学意义(P<0.05);术后3个月,观察组患者的CMI、DI、PI评分分别为(0.11±0.02)分、(0.19±0.03)分、(0.03±0.01)分,明显低于对照组的(0.15±0.03)分、(0.25±0.04)分、(0.05±0.02)分,差异均有统计学意义(P<0.05);观察组患者的术后并发症总发生率为3.92%,明显低于对照组的17.65%,差异有统计学意义(P<0.05)。结论牵引复位固定术在髁突低位骨折患者中的应用可有效降低患者的CMI、DI、PI,临床应用效果显著,且并发症少。Objective To study the effect of traction reduction and fixation in patients with low condylar fracture and its effect on temporomandibular joint disorder index(CMI),temporomandibular dysfunction index(DI),palpation index(PI).Methods A total of 102 patients with low condylar fracture admitted to Ankang Hospital of Traditional Chinese Medicine from January 2016 to January 2022 were selected for a prospective study.They were divided into an observation group and a control group according to random number table method,with 51 patients in each group.Patients in the control group were treated with rigid internal fixation,while patients in the observation group were treated with traction reduction and fixation on the basis of the control group.The clinical efficacy at 2 weeks after surgery and perioperative situation were compared between the two groups.The changes of CMI,DI,and PI before surgery and at 3 months after surgery and the incidence of postoperative complications were also compared.Results The total effective rate of treatment in the observation group was 92.16%,which was significantly higher than 76.47%of the control group(P<0.05).The operation time in the observation group was(67.23±6.83)min,which was significantly longer than(63.40±6.23)min of the control group;the length of hospital stay in the observation group was(8.62±1.18)d,which was significantly shorter than(9.30±1.05)d of the control group;the differences were statistically significant(P<0.05).After surgery 3 months,the CMI,DI,and PI scores in the observation group were(0.11±0.02)points,(0.19±0.03)points,and(0.03±0.01)points,which were significantly lower than(0.15±0.03)points,(0.25±0.04)points,and(0.05±0.02)points of the control group(P<0.05).The total incidence of postoperative complications in the observation group was 3.92%,which was significantly lower than 17.65%in the control group(P<0.05).Conclusion The application of traction reduction and fixation in patients with low condylar fractures can effectively reduce patient's CMI,DI,a

关 键 词：髁突低位骨折 牵引复位固定术 坚固内固定术 颞下颌关节功能 疗效 并发症 

分 类 号：R683[医药卫生—骨科学]