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内镜辅助经口开放式复位和髁突骨折的刚性固定,使用自动复位和固定接骨板。

Catching condyle - Endoscopic-assisted transoral open reduction and rigid fixation of condylar process fractures using an auto reposition and fixation osteosynthesis plate.

机构信息

Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.

Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.

出版信息

J Craniomaxillofac Surg. 2019 May;47(5):778-785. doi: 10.1016/j.jcms.2019.01.047. Epub 2019 Feb 4.

Abstract

INTRODUCTION

Fractures of the mandibular condyle are reported to account for 9 %-45 % of all mandibular fractures. There has been a long lasting controversy on the superiority of different treatment options with endoscopic-assisted transoral approaches gaining increasing attention in recent years. In this article, we report the application of a newly developed osteosynthesis plate for an auto reposition, reconstruction and rigid fixation of condylar process fractures.

MATERIAL AND METHODS

We present 6 cases of uni- or bilateral fractures of the condylar process treated with a transoral open reduction and rigid fixation using an auto reposition plate. Via a transoral endoscopic assisted approach the proximal condyle fragment is captured using an anatomical defined clinch of the cranial part of the plate. The reposition of the condyle is facilitated with the distal bridge of the plate ranging around the posterior part of the ascending ramus.

RESULTS

The results show a sufficient reposition, rigid fixation and no facial nerve palsy or postoperative long-term occlusal disturbances. The mean operating time was 86 min.

CONCLUSION

Transoral endoscopic-assisted surgery with application of an auto reposition, reconstruction and fixation plate offers a quick and convenient way for open reconstruction and rigid fixation of condylar process fractures.

摘要

简介

下颌骨髁突骨折占所有下颌骨骨折的 9%-45%。不同治疗方法的优劣一直存在争议,近年来,内镜辅助经口入路越来越受到关注。本文报道了一种新开发的接骨板在髁突骨折自动复位、重建和坚固固定中的应用。

材料与方法

我们报告了 6 例单侧或双侧髁突骨折患者,采用经口切开复位和使用自动复位板的坚固固定治疗。通过经口内镜辅助入路,使用板的头部解剖定义的压接来捕获近侧髁突骨折块。通过位于升支后段的板的远端桥来辅助髁突复位。

结果

结果显示充分复位、坚固固定,无面神经瘫痪或术后长期咬合紊乱。平均手术时间为 86 分钟。

结论

经口内镜辅助手术应用自动复位、重建和固定板为髁突骨折的开放式重建和坚固固定提供了一种快速方便的方法。

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