下颌骨髁状突骨折坚固内固定的临床评价

The clinical appraisal to rigid internal fixation of the fracture of mandibular condyloid process

目的 探讨下颌骨髁状突骨折坚固内固定术的手术适应证与技术要点。方法 髁状突骨折 4 3例 ,4 1例行开放复位坚固内固定手术 ,所有患者手术前后仔细记录面形、张口受限、面神经损伤及关系紊乱情况 ,手术前后 X线曲面断层片对照骨折复位与愈合改建状况。结果 髁状突骨折 X线复查骨折解剖复位率达90 % ( 37/41) ,张口受限 7例 ,错 3例 ,钛板断裂 1例 ,面神经损伤 7例 ,伤口感染 3例。结论 开放复位坚固内固定术是下颌骨低位髁颈与髁颈下骨折的理想方法 ;髁头与高位髁颈骨折及陈旧性骨折应灵活掌握。

Objective To study the indication and main points of rigid internal fixation techniques in fractures of mandibular condyloid process.Methods There were 43 patients with fractures of condyloid process.Rigid internal fixation was applied in 41 cases.The facial outline,restriction of mouth opening degress and injury of facial nerves were carefully recorded before and after operation.At the same time,orthopantomography was used to evaluate the reduction and heal of the fracture fragments.Results According to X ray pictures,the rate of anatomical reduction is 90.2% (37/41).Restriction of mouth opening can be seen in 7 cases;patho occlusion in 3 cases;fracture of titanium plates,1 case;injury of facial nerves,7 cases;infection of incisions,3 cases.ConclusionIt is an ideal method to use rigid internal fixation in operation of fractures of the neck or lower condyloid process.As to the head or upper fractures of it,the treatment is more flexible.