侧向长螺钉和微型钛板联合固定髁突囊内骨折

Surgical Treatment of Intracapsular Fractures of Mandibular Condylar Using Lateral Long Screws Combined with Titanium Microplates

目的:探讨侧向长螺钉和微型钛板联合固定髁突囊内骨折的疗效。方法:对10例(13侧)髁突囊内骨折患者选择侧向长螺钉和微型钛板联合固定髁突囊内骨折,并同期行关节盘复位。结果:10例患者伤口均一期愈合,术后冠状位CT显示骨折断端对位良好。9例患者咬合关系恢复正常,1例患者后牙轻度开牙合,术后颌间牵引1周后咬合关系恢复。术后1个月复查,最大张口度34～45mm(平均39mm),前伸运动及侧向运动均大于5mm,开口型无偏斜。3例侧出现面神经颞支损伤症状,术后3个月复查时恢复正常,无1例出现永久性面瘫。结论:对于骨折线经过髁突头外1/3的囊内骨折,侧向长螺钉和微型钛板联合固定是可靠的固定方法。

Objective： To discuss the efficiency of fixation of intracapsular fractures of the mandibular condyle utili zing lateral long screws combined with a titanium microplates. Methods： A clinical study was conducted on 10 pa tients with 13 intracapsular fractures of the mandibular condyle. The fractures were treated surgically using lateral long screws combined with titanium microplates for internal fixation. Results： Thirteen fractures in i0 patients were fixed with lateral long screws combined with titanium microplates. Primary healing occurred in all cases. Postopera rive coronal CT images showed reposition of the proximal fragments. Except for a slight degree of transient postop- erative open bite in one case, all cases achieved perfect occlusion one month after operation. Postoperative maximal mouth opening was 34--45mm （mean 39mm）. Three cases had transient facial palsy and recovered in 3 months. No patients had permanent facial palsy. Conclusion： Fixation with lateral long screws combined with titanium micro plates might be reliable for surgical treatment of type A intracapsular fractures of the mandibular condyle.