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使用成角螺丝刀经口内入路治疗髁突骨折:一项多中心研究的结果

Treatment of condylar fractures with an intraoral approach using an angulated screwdriver: results of a multicentre study.

作者信息

Vajgel André, Santos Thiago de Santana, Camargo Igor Batista, de Oliveira David Moraes, Laureano Filho José Rodrigues, Vasconcellos Ricardo José de Holanda, Lima Sergio Monteiro, Pereira Filho Valfrido A, Mueller Andreas A, Juergens Philipp

机构信息

University of Pernambuco - School of Dentistry (FOP/UPE), Camaragibe, PE, Brazil.

Ribeirão Preto School of Dentistry (FORP/USP), Ribeirão Preto, SP, Brazil.

出版信息

J Craniomaxillofac Surg. 2015 Jan;43(1):34-42. doi: 10.1016/j.jcms.2014.10.006. Epub 2014 Oct 17.

Abstract

BACKGROUND

This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach.

METHODS

Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up.

RESULTS

The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 ± 16.60 years. The median duration of postoperative follow-up was 24.39 ± 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement.

CONCLUSION

Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture.

摘要

背景

本多中心研究旨在调查使用成角螺丝刀系统及经口内手术入路进行开放坚强内固定治疗髁突骨折后的长期影像学和功能结果。

方法

对29例共32处髁突骨折患者进行评估。基于以下变量对患者进行前瞻性调查:年龄、性别、病因、患侧、骨折部位和分类、移位程度、合并骨折、手术入路、口腔健康状况、接骨板类型、手术时间、开口度、并发症及随访时间。

结果

骨折分类为髁突下骨折(n = 25)或髁突颈部骨折(n = 7)。患者平均年龄为36.38 ± 16.60岁。术后随访的中位时间为24.39 ± 13.94个月。未观察到关节弹响、面神经麻痹、关节疼痛或肌肉疼痛。为治疗1例伴有内侧移位的髁突下骨折,需额外采用下颌后入路。

结论

伴有内侧或外侧移位的髁突下或髁突颈部骨折可采用口内入路治疗,效果满意,具有无可见瘢痕、避免面神经损伤及能快速到达骨折部位的优点。

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