Oral and Maxillofacial Surgery Service, Hospital João XXIII/FHEMIG, Minas Gerais, Brasil.
Dent Traumatol. 2011 Jun;27(3):235-40. doi: 10.1111/j.1600-9657.2011.00980.x. Epub 2011 Feb 23.
Superolateral dislocation of the intact mandibular condyle (SDIMC) is rare. This case report focuses on a 15-year-old teenager who was involved in a motor vehicle accident as well a literature review regarding the SDIMC. Clinical examination demonstrated a diffuse edema in the midfacial area and a left lateral deflection of the mandible, including an open bite and a crepitation in the symphyseal region. Three-dimensional computed tomography scans were taken, which presented a superolateral dislocation of the left mandibular condyle as well as panfacial fracture. The patient was set in intermaxillary fixation for 2 weeks and underwent subsequent active jaw physiotherapy, the evaluation of which presented satisfactory results. This case study also presents a literature review, which demonstrated 21 well-documented cases of SDIMC. The patients' mean age was of 29 years. The male gender proved to be more prevalent, with road traffic collisions representing the most common form of accident. Type II, with unilateral dislocation, proved to be the most common. The mean reduction time was 7 days. The open methods were the most commonly used reduction methods. Mandible fracture was associated with dislocation in 82% of the cases, with other facial fractures appearing in only 23% of the cases. Patient follow up presented satisfactory results in 59% of the cases.
完整下颌骨髁突外侧脱位(SDIMC)罕见。本病例报告重点介绍了一名 15 岁青少年,他在机动车事故中受伤,并对 SDIMC 进行了文献回顾。临床检查显示中面部弥漫性水肿,下颌骨左侧偏斜,包括开颌和联合区弹响。进行了三维 CT 扫描,显示左侧下颌骨髁突外侧脱位和全颌面部骨折。患者接受了 2 周的颌间固定,随后进行了主动颌骨物理治疗,评估结果令人满意。本病例研究还进行了文献回顾,共纳入 21 例经充分证实的 SDIMC 病例。患者的平均年龄为 29 岁。男性更为常见,道路交通碰撞是最常见的事故形式。II 型,单侧脱位,最为常见。平均复位时间为 7 天。开放式复位方法是最常用的复位方法。下颌骨骨折与脱位相关的占 82%,其他面骨骨折仅占 23%。59%的病例患者随访结果满意。