髁突颈部骨折开放复位术临床及X线影像分析

Evaluation of Open Treatment of Fracture of Condylar Process by X-ray Examination

目的 :分析髁突颈部骨折的X线影像学特点及临床表现 ;评价开放复位术后临床及X线结果。方法 :对2 0例 32侧髁突骨折手术治疗前后的临床表现及X线影像进行分析。结果 :X线片显示均为伴有移位的髁突颈部骨折 ,髁突仍位于关节窝内的 2 2侧 ,位于关节窝以外的 10侧 ;骨折片间移位形成夹角 ,平均为 4 2 .78°,大于 90°者 5例 ,小于 90°者 2 7例。临床表现 :咬牙合关系紊乱、开口受限、开口型异常、下颌前伸及侧方运动障碍、面型不对称等 ,手术治疗后均得到改善 ,且病人主观感觉满意。术后X线片显示骨断端间对位良好。结论 :髁突颈部骨折影响患者咬牙合功能 ;骨断端间移位形成夹角 (大于 4 0°)的病例可作为手术治疗的适应证 ;手术前后的X线诊断及随访应被认为是治疗过程中的一个不可缺少的重要环节。

Objective: To evaluate the clinical manifestation and X-ray image of fracture of condylar process after open treatment. Methods: 20 cases with 32 operated condylar processes were analyzed by clinical examination and X-ray image. Results: All fractures occurred in the neck region of the condylar process in company with fragment displacement. 10 were extracapsular type and 22 were intracapsular type. Postopeative clinical and X-ray examination showed excellent result. Conclusion: Fracture of condylar process in company with fragment displacement, which could affect occlusial relation and result in the anger between fragments displaced> 42.78° should be regarded as the indication for open treatment; Pre- and postoperative X-ray examination play an important role in treatment course.