Suhas S, Ramdas Sharad, Lingam P P, Naveen Kumar H R, Sasidharan Aashish, Aadithya R
Department of Plastic and Reconstructive Surgery, Pondicherry Institute of Medical Sciences, Puducherry, India.
Indian J Plast Surg. 2017 May-Aug;50(2):207-212. doi: 10.4103/ijps.IJPS_125_16.
Condylar fractures of the mandible are functionally important fractures as the condyle of the mandible being a part of the temporomandibular joint (TMJ) and can lead to TMJ dysfunction if not properly treated.
This was a cross-sectional study of a total of 33 treated patients with fracture of the mandibular condyle who underwent examination as per the Helkimo index. Their dysfunction was quantified and clinicoepidemiological characteristics were assessed. It was found that majority of our patients were young males involved in a two-wheeler accident. All patients underwent intermaxillary fixation as the minimum treatment and 30% underwent open reduction and internal fixation in addition.
There was no statistically significant association between the degree of clinical dysfunction and factors such as age, mechanism of injury, type of condyle fracture, presence of other mandible fractures, and surgical procedure. However, dislocation of the mandibular condyle was found to be a negative prognostic factor and all these patients had some degree of dysfunction.
The overall prevalence of TMJ dysfunction according to the Helkimo index was 90%. About 61% of patients had mild dysfunction (Di1) and 30% had moderate dysfunction (Di2). None of the patients had severe dysfunction. To conclude, the Helkimo index is a simple, effective, inexpensive, reliable screening index to assess TMJ dysfunction in condylar fractures of mandible.
下颌骨髁突骨折是功能上重要的骨折,因为下颌骨髁突是颞下颌关节(TMJ)的一部分,如果治疗不当可导致颞下颌关节功能障碍。
这是一项横断面研究,共纳入33例接受治疗的下颌骨髁突骨折患者,根据赫尔基莫指数进行检查。对他们的功能障碍进行量化,并评估临床流行病学特征。发现我们的大多数患者是涉及两轮车事故的年轻男性。所有患者至少接受颌间固定治疗,另外30%的患者接受切开复位内固定治疗。
临床功能障碍程度与年龄、损伤机制、髁突骨折类型、其他下颌骨骨折的存在以及手术方式等因素之间无统计学显著关联。然而,发现下颌骨髁突脱位是一个负面预后因素,所有这些患者都有一定程度的功能障碍。
根据赫尔基莫指数,颞下颌关节功能障碍的总体患病率为90%。约61%的患者有轻度功能障碍(Di1),30%的患者有中度功能障碍(Di2)。没有患者有严重功能障碍。总之,赫尔基莫指数是评估下颌骨髁突骨折中颞下颌关节功能障碍的一种简单、有效、廉价、可靠的筛查指数。