髁突-翼外肌解剖复位术与游离复位术治疗下颌骨髁状突骨折的疗效对比

Comparison on the curative effect of dissection and free reduction for condylar fracture of mandibular condyle

目的:探讨髁突-翼外肌解剖复位术与游离复位术治疗下颌骨髁状突骨折的疗效及安全性。方法:收治下颌骨髁状突骨折患者50例,随机分为观察组和对照组。观察组给予髁突-翼外肌解剖复位术治疗,对照组给予游离复位术治疗。结果:观察组治愈率高于对照组(P<0.05);术后3个月两组患者的髁状突吸收、张口受限、开口偏斜、咬合关系紊乱、关节弹响的发生率比较,差异有统计学意义(P<0.05);术后6个月两组的张口受限、关节弹响的发生率比较,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论:髁突-翼外肌解剖复位术对髁状突骨折的治疗效果更好,且并发症发生率较低,适应证广泛,而游离复位治疗更适于髁状突高位骨折。

Objective:To investigate the efficacy and safety of dissection and free reduction for condylar fracture of the mandibular condyle.Methods:50 patients with mandibular condyle fracture were selected.They were randomly divided into the observation group and the control group.The observation group were treated with anatomical reduction of condyle and lateral pterygoid muscle,while the control group were treated by free reduction.Results:The cure rate of the observation group was higher than that of the control group(P<0.05);3 months after surgery,the differences in condylar absorption,trismus,opening deviation,occlusion disorder,arthrosnap occurrence rates between groups were statistically significantly(P<0.05);6 months after surgery,the differences in trismus joint,the incidence of snapping were statistically significantly(P<0.05);the incidence of complications in the observation group lower than in the control group(P<0.05).Conclusion:The anatomic reduction of condyle and lateral pterygoid muscle is a better treatment for condylar fractures,with a low incidence of complications and wide indications,and free reduction is more suitable for high condylar fractures.