28例颏部骨折合并髁突囊内骨折伴脱位的疗效分析

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (1): 68-72.

28例颏部骨折合并髁突囊内骨折伴脱位的疗效分析

徐晓峰^*, 史俊^*, 徐兵, 苏佳楠

上海交通大学医学院,上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科,上海市口腔医学重点实验室,上海 200011

收稿日期:2014-04-14 出版日期:2015-02-10 发布日期:2015-03-12
通讯作者: 徐兵,E-mail:bingxu568@hotmail.com E-mail:xuxiaofeng110@163.com;shijun.oms@gmail.com
作者简介:徐晓峰(1989-),男,硕士;史俊（1974-）,男,博士,副主任医师。*并列第一作者

Mandibular symphyseal and parasymphyseal fracture combined with dislocated intracapsular condyle fractures: analysis of treatment results in 28 consecutive cases

XU Xiao-feng, SHI Jun, XU Bing, SU Jia-nan

Department of Oral and Cranio maxillofacial Science, Ninth People′s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine Shanghai Key Lab of Stomatology. Shanghai 200011, China

Received:2014-04-14 Online:2015-02-10 Published:2015-03-12

摘要/Abstract

摘要： 目的探讨下颌骨颏部骨折合并髁突囊内骨折伴脱位的治疗方法,并比较髁突骨折不同处理方法对治疗效果的影响。方法 2008—2013年间收治28例、44侧颏部骨折合并髁突囊内骨折患者,22侧髁突囊内骨折采用手术治疗,手术中注意保护翼外肌的附着;其余22侧采取保守治疗,术前或术中取模,术后配戴颌垫并配合弹性牵引及开口训练。应用SPSS17.0软件包对治疗结果进行Wilcoxon秩和检验。结果手术治疗组髁突骨折22侧,术后髁突位置基本回复到关节窝内17侧,其牙弓宽度及咬合关系基本恢复,术后髁突仍然脱出关节窝5侧;保守治疗组22侧,术后髁突成功回复到关节窝内4侧,其余18侧脱出关节窝,其面下1/3仍有不同程度增宽。手术治疗组疗效评分显著优于保守治疗组（P<0.01）。结论对颏部骨折合并髁突囊内骨折伴脱位患者,应在保持翼外肌良好附着的前提下,对脱位的髁突骨折进行复位和固定,这样有利于脱位的髁突恢复到正常的生理位置,维持下颌骨的正常宽度。

关键词: 下颌骨骨折, 髁突囊内骨折, 髁突脱位, 下颌骨宽度

Abstract: PURPOSE: To evaluate the treatment results of mandibular symphyseal and parasymphyseal fracture combined with dislocated intracapsular condyle fractures in 28 consecutive cases. METHODS: Twenty-eight patients treated in our department during 2008 to 2013 were included in this study, in which 22 sides were treated by open reduction and the medial condylar fragments were fixed with titanium screws, while the other 22 sides underwent conservative close treatment. The treatment outcomes were followed up, evaluated and analyzed with SPSS 17.0 software package for Wilcoxon test. RESULTS: Seventeen of 22 condyle fractures were repositioned in surgery group which was much better than 4 of 22 in close treatment group (P<0.01). Functional outcomes of the patients treated with surgical treatment group were better than the close treatment group. CONCLUSIONS: The dislocated intracapsular condyle fractures should be treated by surgical reduction with the maintenance of the attachment of lateral pterygoid muscle in this kind of fracture, because it is beneficial to repositioning the condyle fractures, closing the lingual gap and maintaining the width of mandible.

Key words: Mandibular fracture, Intracapsular condyle fracture, Dislocated condyle fracture, Width of mandible

中图分类号:

R782.2.6

徐晓峰, 史俊, 徐兵, 苏佳楠. 28例颏部骨折合并髁突囊内骨折伴脱位的疗效分析[J]. 中国口腔颌面外科杂志, 2015, 13(1): 68-72.

XU Xiao-feng, SHI Jun, XU Bing, SU Jia-nan. Mandibular symphyseal and parasymphyseal fracture combined with dislocated intracapsular condyle fractures: analysis of treatment results in 28 consecutive cases[J]. China J Oral Maxillofac Surg, 2015, 13(1): 68-72.

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