下颌骨外伤致颞下颌关节间接钝挫伤的临床观察

Clinical investigation of temporomandibular joint blunt trauma induced by mandible impact

目的 初步探讨下颌骨外伤引起颞下颌关节间接钝挫伤的主要病变类型及创伤性关节炎的概念。方法 对 4 1例下颌骨外伤后无髁突骨折但发生一侧或双侧颞下颌关节创伤性关节炎病例的临床及影像学资料进行分析。结果 颏部和 (或 )下颌角外伤共 30例 ,占本组病例 70 %以上 ;本组病例可分为 :主要表现为关节盘病变、滑膜炎、咀嚼肌炎、关节内粘连或混合性病变。结论 颏部或下颌角外伤是造成关节间接性钝挫伤的主要创伤类型 ;关节钝挫伤所致的创伤性关节炎临床上多表现为混合性病变 ;关节钝挫伤所致的急慢性创伤性关节炎的时间界定以 1个月为宜。

Objective To investigate the main types of the blunt trauma of temporomandibular joint (TMJ) induced by mandible impact and to discuss the concept of TMJ traumatic arthritis.Methods The radiograph and clinical data of 41 cases with TMJ traumatic arthritis but without condylar fractures was investigated.Results It has been found that 70% of the impact sites were mentums and/or mandible angles;all the cases in the present study could be classified into the disk disorders,synovitis,myositis of jaw muscle,adhesion,and mixed pathological changes.Conclusion TMJ blunt trauma was mainly induced by the impact of mandible mentum and angle;TMJ traumatic arthritis induced by blunt trauma was mainly mixed pathological changes and a period of one month was suggested to be the boundary of the acute and chronic traumatic arthritis.