Zrounba Hugues, Lutz Jean-Christophe, Zink Simone, Wilk Astrid
Service de Chirurgie Maxillo-Faciale (Head: Prof. Astrid Wilk), Hopital Civil, 1, Place de L'hopital, 67000 Strasbourg, France.
Service de Chirurgie Maxillo-Faciale (Head: Prof. Astrid Wilk), Hopital Civil, 1, Place de L'hopital, 67000 Strasbourg, France.
J Craniomaxillofac Surg. 2014 Sep;42(6):879-84. doi: 10.1016/j.jcms.2014.01.002. Epub 2014 Jan 10.
Surgical management of mandibular condyle fractures is still controversial. Although it provides better outcome than closed treatment questions still remain about the surgical approach and the osteosynthesis devices to be used. Between 2005 and 2010, we managed 168 mandibular condyle fractures with open treatment. Two surgical approaches were used in this study, a pre-auricular and a high submandibular approach (one or the other or as a combined approach). Internal fixation was performed using TCP(®) plates (Medartis, Basel, Switzerland) or with two lag screws (15 and 17 mm). Delta plates were used in 15 cases (8.9%). We report the epidemiology of these fractures and the outcomes of the surgical treatment. We assessed the complications related to the surgical procedure and those related to the osteosynthesis material. The facial nerve related complication rate was very low and the osteosynthesis materials used proved to be strong enough to realize a stable fixation. The two approaches used in this study appeared to be safe with good aesthetic results. Most of the surgical procedure failures occurred in high subcondylar fractures especially when bilateral.
下颌骨髁突骨折的手术治疗仍存在争议。尽管手术治疗比保守治疗效果更好，但关于手术入路和所使用的接骨装置仍存在问题。2005年至2010年间，我们采用开放治疗方法处理了168例下颌骨髁突骨折。本研究使用了两种手术入路，即耳前入路和下颌下高位入路（单独使用一种或联合使用）。使用TCP(®)接骨板（瑞士巴塞尔Medartis公司）或两枚拉力螺钉（15和17毫米）进行内固定。15例（8.9%）使用了三角接骨板。我们报告了这些骨折的流行病学情况以及手术治疗的结果。我们评估了与手术操作相关的并发症以及与接骨材料相关的并发症。面神经相关并发症发生率非常低，并且所使用的接骨材料被证明足以实现稳定固定。本研究中使用的两种入路似乎是安全的，且美容效果良好。大多数手术失败发生在髁突高位骨折，尤其是双侧骨折时。
