利用改良巾钳进行解剖复位治疗高位髁突骨折

Anatomical reduction of high condylar fractures by using a modified towel forceps

目的:评价利用特制巾钳辅助复位,治疗高位髁突骨折的疗效。方法 :对28例高位髁突骨折患者经耳前进路行髁突解剖复位,术中保留骨折端的翼外肌附着,用微型钛板及螺钉固定,6个月后进行临床疗效评估和影像学观察。结果:2例患者出现轻度开口受限,1例出现开口偏斜,3例出现关节弹响。术后6个月临床评价治愈率达78.6%,影像学评价治愈率达92.8%。结论:利用特制巾钳进行髁突高位骨折解剖复位,避免了术后髁突吸收及畸形改变,有利于颞下颌关节功能的恢复。

PURPOSE： To evaluate the clinical effects of anatomic reduction of high condylar fractures by using a modified towel forceps. METHODS： Twenty-eight patients with high condylar fractures were treated with anatomic reduction and internal fixation. All cases were evaluated by clinical examination and imaging examination 6 months after operation. RESULTS： Two patients had limited mouth opening, one patients developed mandible deviation during mouth opening, and 3 patients presented joint clicking symptom, no absorption or deformation of the condylar process was found by imaging examination 6 months postoperatively. The cure rate by clinical examination was 78.6%, and 92.8% by imaging examination. CONCLUSIONS： Anatomic reduction of high condylar fractures by using a modified towel forceps is an useful method. It can reduce the incidence of absorption and deformity of the condyle, and help to restore the function of the temporomandibular joint.