Choi Kang-Young, Yang Jung-Dug, Chung Ho-Yun, Cho Byung-Chae
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
Arch Plast Surg. 2012 Jul;39(4):301-8. doi: 10.5999/aps.2012.39.4.301. Epub 2012 Jul 13.
In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.
在治疗下颌髁突骨折时，可采用闭合复位的保守治疗或切开复位的手术治疗。下颌髁突骨折的处理在口腔颌面创伤领域仍是一个持续存在争议的问题。对于每种类型的髁突骨折，必须考虑牙齿的存在情况、骨折高度、患者适应性、患者咀嚼系统、咬合功能紊乱以及下颌偏斜等因素来选择治疗方法。过去，主要采用在恢复期行颌间固定后进行闭合复位并辅以积极物理治疗的方法，但近年来，采用坚固内固定的髁突骨折切开治疗更为常见。本综述的目的是评估决定髁突骨折开放或闭合治疗方法选择的主要变量，确定其适应证、优点和缺点，并评价目前关于下颌髁突骨折治疗中所用干预措施有效性的证据。
