Baek Rong-Min, Min Kyung-Hee, Heo Chan-Yeong, Eun Seok-Chan
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Bundang Hospital, 300 Gumi-dong, Bundang, Gyeonggi-do, Korea.
Ann Plast Surg. 2011 Mar;66(3):253-6. doi: 10.1097/SAP.0b013e3181e1333f.
Several approaches to the management of subcondylar fractures have been used, including the submandibular approach, the preauricular approach, and the retromandibular approach. Although they provide excellent access to repair fractures of body, ramus, and condyle, we have found it difficult to manage subcondylar fractures using either of these approaches. We describe a novel approach for subcondylar fractures that provides direct access to the fracture site. A total of 17 consecutive patients underwent open reduction and internal fixation of their subcondylar fractures using this technique. The incision line is located just anterior and posterior to the ear lobe, and is comprised of lower part preauricular and upper retroauricular incisions. Intraoperatively, the method applied shortened the time necessary for and simplified the procedure of reduction and osteosynthesis. The postoperative course was uneventful in most patients. Radiologic follow-up revealed correct reduction and fixation in all the cases. There were no occlusal disturbances, no trismus, no lateral deviations of the mandible, and no nerve lesions. Our findings indicate that the short perilobe approach is an easy and safe technique for displaced subcondylar fractures.
髁突骨折的治疗方法有多种，包括下颌下入路、耳前入路和下颌后入路。尽管这些方法能很好地显露下颌体、下颌支和髁突骨折的部位以便进行修复，但我们发现使用这些方法中的任何一种来治疗髁突骨折都很困难。我们描述了一种治疗髁突骨折的新方法，该方法能直接显露骨折部位。共有17例连续患者采用该技术对其髁突骨折进行切开复位内固定。切口线位于耳垂前后，由耳前下部切口和耳后上部切口组成。术中，应用的方法缩短了复位和骨固定所需的时间并简化了操作过程。大多数患者术后恢复顺利。影像学随访显示所有病例均复位及固定良好。无咬合紊乱、无牙关紧闭、无下颌骨侧向偏斜、无神经损伤。我们的研究结果表明，短耳垂旁入路是治疗移位髁突骨折的一种简单且安全的技术。
