下颌骨创伤致慢性颞下颌关节创伤性关节炎相关因素的初步分析

Analysis of possible factors resulting in chronic traumatic arthritis of temporomandibular joint after mandible fractures

目的 初步探讨下颌骨骨折后颞下颌关节发生慢性创伤性关节炎的相关因素。方法 对下颌骨骨折后 37例颞下颌关节慢性创伤性关节炎病例 (A组 )和 83例无关节症状病例 (B组 )的临床资料进行比较分析。结果 A组较B组女性及成人比例多 ;颌间结扎时间长 ,开口练习执行情况差 ;髁突骨折病例多 ,经保守治疗的髁突脱位骨折病例多。结论 下颌骨骨折引起的颞下颌关节慢性创伤性关节炎易发于颌间结扎时间长、未能进行完善开口练习的患者 ,且成年及女性患者多见 ;髁突骨折是引起该病的主要创伤类型 ,其中保守治疗的髁突脱位骨折患者更易发生慢性创伤性关节炎 ;下颌骨其它部位骨折者也可引起慢性创伤性关节炎 ,应引起临床工作者重视。

Objective To investigate the factors resulting in chronic traumatic arthritis of temporomandibular joint (TMJ)after mandible fractures.Methods Thirty-seven patients(group A) with chronic traumatic arthritis of TMJ after mandible fractures and 83 cases of mandible fractures but without TMJ symptoms(group B) were investigated clinically and radiologically.Results It has been found more adult and female patients, more patients with condylar fractures especially the dislocated condylar fractures and less patients with opening exercises in group A than that in group B.It has also been found that the maxillar and mandibular fixtation (MMF) time of the patients was longer in group A than in group B.Conclusion TMJ chronic traumatic arthritis could be related to long time of MMF,ineffective opening exercise and condylar fracture,especially related to the dislocated condylar fracture.It could also happen in the patients with fractures of mandible but not in the condyle,while female patients tend to suffer from this disease.