髁突摘除术治疗粉碎性髁突骨折疗效分析

Mandibular condyle ectomy for the treatment of comminuted condylar fracture

目的:探讨髁突颈部以上粉碎性骨折行髁突摘除术的可行性及适应证。方法 :回顾我院2007年9月—2011年9月间因外伤导致髁突骨折患者61例,其中完全行手术内固定治疗30例,保守治疗15例,髁突颈部以上粉碎性骨折患者16例(18侧)予以髁突摘除术,术后随访5～48个月,观察疗效。结果:16例(18侧)患者中,止血纱布排异反应导致创口愈合不良1例,咬合偏斜1例,开口轻度受限1例,前牙开1例,其余患者无明显咬合不适,牙尖窝关系良好,面容基本对称。结论:对于颌面部发育基本完成的患者,其髁突颈部以上粉碎性骨折采取髁突摘除术是可行的治疗方法,术后可能出现咬合偏斜、前牙开及开口受限,进一步治疗后可恢复正常。

PURPOSE： To investigate the feasibility and indication of condylectomy for treatment of comminuted fractures of the condyle above the neck.METHODS： Sixty-one patients with condylar fractures,treated between September 2007 and September 2011 were reviewed respectively.Among them,30 underwent open reduction and internal fixation,15 underwent conservative therapy,and 16 patients（18 sides） who had comminuted fractures of the condyle above the neck underwent condylectomy.All the patients were followed up for 5 to 48 months after treatment to evaluate the outcomes. RESULTS： Among the 16 patients with condylectomy,poor wound healing due to rejection of hemostatic gauze was noted in 1 patient,occlusal deviation occurred in 1 patient,mild mouth opening limitation happened in 1 patient,and anterior open bite was present in 1 patient.The other patients recovered well,without apparent discomfort,malocclusion and facial asymmetry.CONCLUSIONS： For patients with finished maxillofacial growth,condylectomy is a feasible and effective way for management of comminuted fractures of the condyle above the neck.Postoperative occlusal deviation,open bite and limited mouth opening can be corrected with further expectant treatment.