Kanno T, Sukegawa S, Tatsumi H, Nariai Y, Ishibashi H, Furuki Y, Sekine J
Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan; Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan.
Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan.
Int J Oral Maxillofac Surg. 2014 Feb;43(2):177-84. doi: 10.1016/j.ijom.2013.08.008. Epub 2013 Sep 23.
We evaluated the safety, efficacy, and morbidity associated with the treatment of displaced mandibular condylar neck fractures using a retromandibular transparotid approach to reduce and rigidly fix using two 2.0-mm locking miniplates. Our surgical inclusion criteria were: patient selection of open reduction and fixation, displaced unilateral condylar fractures with derangement of occlusion, and bilateral condylar fractures with an anterior open bite. The study group consisted of 19 patients who underwent surgery for 19 mandibular condylar neck fractures; patients were analyzed prospectively, with more than 6 months of follow-up, and were evaluated in terms of functional results, scar formation, postoperative complications, and stability of fixation. The results showed that functional occlusion identical to the preoperative condition and correct anatomical reduction of the condylar segments in centric occlusion, followed by immediate functional recovery, was achieved in all patients. No patient suffered from any major or permanent complication postoperatively, although there were two cases (11%) of temporary facial nerve palsy, which resolved completely within 3 months. Surgical scars were barely visible. The retromandibular transparotid approach with open reduction and rigid internal fixation for displaced condylar neck fractures of the mandible is a feasible and safe, minimally invasive surgical technique that provides reliable clinical results.
我们评估了采用下颌后入路经腮腺切开复位并用两块2.0毫米锁定微型钢板坚固固定移位下颌髁突颈部骨折的安全性、有效性及并发症情况。我们的手术纳入标准为：选择切开复位内固定的患者，单侧髁突骨折移位伴咬合紊乱，以及双侧髁突骨折伴前牙开牙合。研究组包括19例接受手术治疗19处下颌髁突颈部骨折的患者；对患者进行前瞻性分析，随访时间超过6个月，并从功能结果、瘢痕形成、术后并发症及固定稳定性方面进行评估。结果显示，所有患者均实现了与术前情况相同的功能性咬合，髁突节段在正中咬合时解剖复位正确，随后功能立即恢复。术后无患者出现任何严重或永久性并发症，尽管有2例（11%）出现暂时性面神经麻痹，但在3个月内完全恢复。手术瘢痕几乎不可见。下颌后入路经腮腺切开复位内固定治疗下颌髁突颈部移位骨折是一种可行、安全的微创手术技术，可提供可靠的临床效果。
