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创伤后髁上外侧脱位:18例髁病例系列并文献复习及分类建议

Post-traumatic superolateral dislocation of condyle: A case series of 18 condyles with review of literature and a proposed classification.

作者信息

Bhutia Dichen Palmo, Mehrotra Divya, Mahajan Nitin, Howlader Debraj, Gamit Jagdish

机构信息

Dept. Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, India.

出版信息

J Oral Biol Craniofac Res. 2017 May-Aug;7(2):127-133. doi: 10.1016/j.jobcr.2017.04.008. Epub 2017 May 4.

Abstract

AIM

The aim is to review the English literature for post-traumatic superolateral dislocation of mandibular condyle (SDMC),discuss their dynamics and clinical management and to propose to modify the existing classification of SDMC.

PATIENTS AND METHODS

A literature search was carried at Pubmed, Sciencedirect, Google and references from reported articles were crosschecked to look for the cases of SDMC from 1969 to 2015 in English language. Also, we have reviewed 11 of our patients with total of 18 superolateral dislocated intact or sagittal split condyles ,who visited our unit in the previous two years.

RESULTS

In our retrospective analysis 58 cases of SDMC were found in the literature, of which 38 had intact mandibular condyles and 20 had sagittal split. Early and intact SDMC were successfully managed conservatively with closed reduction, whereas old cases and largely fractured condyles necessitated open reduction. Additionally, we observed an unusual dislocation associated with fracture of contralateral posterior mandible(angle) in our series which did not gratify the existing classification.

CONCLUSION

Alteration of the existing classification was required to accommodate the unusual type of dislocation.

摘要

目的

回顾关于创伤后下颌髁突上外侧脱位(SDMC)的英文文献,探讨其机制及临床处理方法,并提议对现有的SDMC分类进行修改。

患者与方法

在PubMed、ScienceDirect、谷歌进行文献检索,并对所报道文章的参考文献进行交叉核对,以查找1969年至2015年英文报道的SDMC病例。此外,我们回顾了过去两年间在我院就诊的11例患者,共有18个上外侧脱位的完整或矢状劈开髁突。

结果

在我们的回顾性分析中,文献报道了58例SDMC,其中38例下颌髁突完整,20例为矢状劈开。早期且髁突完整的SDMC通过闭合复位保守治疗成功,而陈旧病例及大部分髁突骨折者则需要切开复位。此外,我们在本系列中观察到1例与对侧下颌后缘(角)骨折相关的特殊脱位,不符合现有分类。

结论

需要改变现有分类以适应这种特殊类型的脱位。

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