口腔医学研究

口腔医学研究 ›› 2016, Vol. 32 ›› Issue (11): 1179-1182.DOI: 10.13701/j.cnki.kqyxyj.2016.11.017

• 临床研究论著 • 上一篇    下一篇

髁突矢状骨折继发颞下颌关节强直31例临床分析

向国林1,邓末宏2,李威2,王琳琳1,任雯1,韩前超1,龙星2*   

  1. 1. 华中科技大学同济医学院附属普爱医院口腔科 湖北 武汉 430033;
    2. 武汉大学口腔医学院口腔颌面外科 湖北 武汉 430079
  • 收稿日期:2016-08-14 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:向国林(1973~ ),男,湖北孝感人,副主任医师,博士,主要从事口腔颌面外科临床工作。
  • 基金资助:
    武汉市卫生计生委临床医学科研项目(编号:WX12D19,WX16D23)

Clinical Analysis of 31 Cases of Temporomandibular Joint Ankylosis Secondary to Condylar Sagittal Fractures

XIANG Guo-lin1, DENG Mo-hong2, LI Wei2, WANG Lin-lin1, REN Wen1, HAN Qian-chao1, LONG Xing2*   

  1. 1. Department of Stomatology, Puai Hospital of Tongji Medical College, Huazhong University of Science and Technology. Wuhan 430033, China;
    2. Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan 430039, China
  • Received:2016-08-14 Online:2016-11-25 Published:2016-11-25

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摘要： 目的:探讨髁突矢状骨折继发创伤性颞下颌关节强直的临床特点。方法:回顾性分析2001～2010年武汉大学口腔医院口腔颌面外科收治的31例、48侧继发于髁突矢状骨折的颞下颌关节强直患者的相关临床资料。结果:31例颞下颌关节强直患者平均外伤年龄15.6岁,其中23例(74.2%)外伤年龄小于16岁。病程3月~20年,平均病程6.5年。42侧强直关节的关节盘发生移位,6侧强直关节的关节盘完全破坏。强直关节标本镜下观察:内侧髁突骨折块发生废用萎缩性改变,外侧骨球区见软骨细胞呈灶性增生成骨,关节盘纤维结构紊乱、玻璃样变性。结论:青少年髁突矢状骨折易发生颞下颌关节强直,关节盘的移位损伤是颞下颌关节强直发生的重要条件。创伤性颞下颌关节强直首先发生在关节外侧,融合骨赘的组织病理学表现为软骨化生、成骨。

关键词: 髁突骨折, 颞下颌关节, 关节强直

Abstract: Objective: To explore the clinical characteristics of traumatic temporomandibular joint ankylosis (TMJA) secondary to condylar sagittal fractures. Methods: Thirty-one patients with a total number of 48 ankylosed temporomandibular joints secondary to condylar sagittal fractures, in the Hospital of Stomatology, Wuhan University during the period of 2001-2010, were retrospectively reviewed. Results: The mean age of patients at injury was 15.6 years old, and 23 patients (74.2%) was less than 16 years old. The time interval between initial injury and presentation of TMJA varied from 3 months to 20 years, with a mean disease course of 6.5 years. The articular discs were observed displaced or disrupted in all 48 ankylosed joints. Histopathology of ankylosed joint revealed that the medially displaced condylar fragments showed the changes of disusatrophy, while cartilaginous metaplasia and ossification were found in the lateral osseous fusions and hyaline degeneration was observed in the disrupted articular discs. Conclusion: Traumatic TMJA secondary to condylar sagittal fractures usually occurred in the adolescents. The damaged articular disc should be account for the development of TMJA. Furthermore, the osseous fusions were initially originated from the lateral of joint surface. Chondrification and endochondral ossification were responsible for the formation of osseous fusions.

Key words: Condylar fractures, Temporomandibular joint, Ankylosis

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