口腔医学研究

口腔医学研究 ›› 2016, Vol. 32 ›› Issue (11): 1183-1187.DOI: 10.13701/j.cnki.kqyxyj.2016.11.018

• 临床研究论著 • 上一篇    下一篇

下颌骨髁突骨折术后并发症的临床研究

张玲阁1,龙星2*,邓末宏2,蔡恒星2,孟庆功2   

  1. 1. 郑州市口腔医院口腔颌面外科 河南 郑州 450000;
    2. 武汉大学口腔医院颞下颌关节唾液腺及唇腭裂外科 湖北 武汉 430079
  • 收稿日期:2016-04-12 出版日期:2016-11-25 发布日期:2016-11-25
  • 通讯作者: 龙星,电话:027—87686216
  • 作者简介:张玲阁(1985~ ),女,河南许昌人,硕士,主治医师,主要从事口腔颌面外科颞下颌关节疾病的研究。

Complications of Surgical Treatment of Mandibular Condylar Fractures

ZHANG Ling-ge1, LONG Xing2*, DENG Mo-hong2, CAI Heng-xing2, MENG Qing-gong2   

  1. 1. Department of Oral and Maxillofacial Surgery, Zhengzhou Stomatologic Hospital, Zhengzhou 450000, China;
    2. Department TMJ, Stomatological Hospital of Wuhan University, Wuhan 430079, China.
  • Received:2016-04-12 Online:2016-11-25 Published:2016-11-25

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摘要： 目的:探讨手术治疗髁突骨折与并发症发生的关系及预防措施。方法:回顾分析采用手术治疗的116例(146侧)髁突骨折病例的临床资料,以开口度、开口型、咬合关系、咀嚼功能、面神经损伤和术后瘢痕等作为术后评价标准;对患者的术前、术后、以及随访的影像片进行数字化分析.随访时间3个月~20年。结果:116例髁突骨折病人中,采取切开复位坚强内固定术86例和髁突摘除术30例。手术开放复位坚强内固定(ORIF)的研究组中,手术进路及固定方式与并发症的发生关系密切,这些并发症包括颞下颌关节紊乱病,下颌偏斜,面神经损伤,术后瘢痕,以及咬合关系紊乱,张口受限甚至关节强直等。结论:根据髁突骨折的分型选择正确的手术方法;髁突骨折手术切开复位坚强内固定效果较好,但不同类型的髁突骨折应选用不同的手术进路及合适的复位固定方法,以最大限度地预防及减少术后并发症的发生。

关键词: 髁突骨折, 手术治疗, 并发症

Abstract: Objective: To explore the complications of condylar fractures after surgical treatment and the preventive measures. Methods: One hundred and forty-six fractured mandibular condyles of 116 patients were treated with open surgery. The parameters for postoperative evaluation were as follows: mouth-opening, mandibular deviation during mouth opening, masticatory function, facial nerve injury and surgical scars. Preoperative, postoperative, and follow-up radiographs were analyzed in the computer. Follow-up time range varied from 3 months to 20 years. Results: Of all the 116 patients, 86 were treated by open reduction and rigid internal fixation (ORIF) and the rest 30 patients were treated by removal of the fractured mandibular condylar fragments without fixation. In the ORIF group, surgical approaches and fixed methods were closely related with the occurrence of complications. Complications occurred in the two groups included temporomandibular disorders (TMD), osteonecrosis, temporary or permanent facial nerve injury, visible scars, malocclusion, deviation of the mandible, facial asymmetry, restricted mandibular movement, and even the development of ankylosis. Conclusion: Treatment plan of condylar fracture should be based on the type of the fracture. Open reduction and rigid internal fixation were effective in the treatment of condylar fractures, however, surgical approach and osteosynthesis should be carefully chosen as the complications were correlated with these two factors.

Key words: Condylar fractures, Surgical treatment, Complications

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