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髁突头部骨折的手术治疗,是将创伤后颞下颌关节强直风险降至最低的方法。

Surgical treatment of condylar head fractures, the way to minimize the postraumatic TMJ ankylosis.

作者信息

Hirjak D, Machon V, Beno M, Galis B, Kupcova I

出版信息

Bratisl Lek Listy. 2017;118(1):17-22. doi: 10.4149/BLL_2017_004.

Abstract

Management of condylar head fractures (CHF) of the temporomandibular joint (TMJ) remains a source of controversy. Based on established literature, group of CHFs and conservative treatment connected with period of maxillomandibular fixation (MMF) increases the risk for TMJ ankylosis. This paper presents anatomical and functional results of surgical treatment of condylar head fractures in a group of 24 patients (29 joints). Fractures were diagnosed based on conventional radiographs and computed tomography (CT) scans. Utilising an intraoperative arthroscopy authors evaluated actual intraarticular posttraumatic changes. This study presents acceptable functional and radiological results of surgical treatment of condylar head fractures with more than 3-year follow-up. The authors believe that re-establishing the pretraumatic anatomic position of the TMJ components (fragment and the disc) and early postoperative rehabilitation are inevitable to minimize the risk of postraumatic TMJ ankylosis (Tab. 2, Fig. 8, Ref. 31).

摘要

颞下颌关节髁突头部骨折(CHF)的治疗仍然存在争议。根据现有文献,一组髁突头部骨折以及与颌间固定(MMF)期相关的保守治疗会增加颞下颌关节强直的风险。本文介绍了一组24例患者(29个关节)髁突头部骨折手术治疗的解剖学和功能结果。骨折通过传统X线片和计算机断层扫描(CT)进行诊断。作者利用术中关节镜评估了实际的关节内创伤后变化。本研究展示了髁突头部骨折手术治疗超过3年随访的可接受的功能和放射学结果。作者认为,重新建立颞下颌关节组件(骨折块和关节盘)的创伤前解剖位置以及术后早期康复对于将创伤后颞下颌关节强直的风险降至最低是必不可少的(表2,图8,参考文献31)。

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