双长钉冠向复位固定下颌骨髁突矢状骨折的临床应用研究

Clinical application of bilateral long screws in the coronal reduction and fixation of sagittal fracture of mandibular condyle

目的探讨长钉在髁突矢状骨折中冠向复位固定治疗中的应用与疗效。方法对20例(24侧)髁突矢状骨折患者骨折复位后采用双长钉冠向固定技术,术后早期行张开训练,术后12月内定期随访。结果所有患者术后疗效满意,骨折片复位固定良好,4例患者4侧术后有额纹不同程度减弱,术后6月内均恢复,术后咬合关系,张口度均恢复正常,1例出现关节后区疼痛不适,随访期内无明显缓解,双侧髁突骨折1例(1侧)出现骨折块再次移位。结论髁突矢状骨折的双长钉冠向复位内固定技术效果明显,方法可靠,可以达到稳定的复位固定,可以减少颞下颌关节强直的发生。

Objective To investigate the application and curative effect of the long screw in the coronal reduction and internal fixation of sagittal condylar fracture. Methods 20 patients（24 sides） with sagittal fracture of condyle were treated with double coronal fixation technique after fracture reduction. Early open training was performed after operation,and regular follow-up was performed within 12 months after operation. Results All the patients with fracture fixation is good,there is no shift and absorption. 4 patients were limited by mouth,and all were restored to normal after 4 weeks of opening. The 4 sides of the 4 patients had different levels of frontal striations after operation,and all recovered within 6 months. the relationship of occlusal and the degree of opening was restored to normal. 1 patient of joint pain and discomfort,during the follow-up period there was no significant relief. 1 patient（1 side） of bilateral condylar fracture reappear displacement of the fracture block. Conclusions The technique of double long screw coronal reduction and internal fixation for sagittal fracture of condyle is effective and reliable. It can achieve stable reduction and fixation,and can reduce the occurrence of ankylosis of temporomandibular joint.