So Byung-Kyu, Ko Kyeong-Soo, Kim Dong-Hyuck, Jang Hyon-Seok, Lee Eui-Seok, Lim Ho-Kyung
Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul 08308, Korea.
Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Ansan 15355, Korea.
J Clin Med. 2021 Dec 10;10(24):5782. doi: 10.3390/jcm10245782.
Occlusal displacement often occurs after surgery for condylar process fractures because it is difficult to reduce these fractures precisely. However, performing semi-rigid fixation using a sliding plate may overcome this limitation. A retrospective clinical comparison between semi-rigid and rigid fixations was performed. Among 34 patients who had unilateral condylar process fractures, 17 were treated with rigid fixation and the remaining with semi-rigid fixation using a sliding plate. For all patients, panoramic radiographs were collected 1 day and 6 months after surgery. In these radiographs, ramus height and condylar process inclination were measured, and the differences between the fractured and normal sides were assessed. Additionally, the radiographic density of the fracture area was measured. Differences in surgical outcomes and operative times between the two groups and changes in postoperative deviations within each group were analyzed. There was no statistically significant difference in ramus height and condylar process inclination between the two groups at postoperative day 1 and 6 months. Radio-density was observed to be higher in the rigid fixation group, and it increased with time in both groups. The semi-rigid fixation group had a significantly shorter operative time than the other group did. Semi-rigid and rigid fixations showed no differences in terms of effectiveness and outcomes of surgery. In terms of operative time, semi-rigid fixation was superior to rigid fixation.
髁突骨折手术后常发生咬合移位,因为精确复位这些骨折很困难。然而,使用滑动钢板进行半刚性固定可能会克服这一局限性。对半刚性固定和刚性固定进行了回顾性临床比较。在34例单侧髁突骨折患者中,17例采用刚性固定治疗,其余采用滑动钢板半刚性固定治疗。对所有患者在术后1天和6个月收集全景X线片。在这些X线片中,测量升支高度和髁突倾斜度,并评估骨折侧与正常侧之间的差异。此外,测量骨折区域的X线密度。分析两组手术结果和手术时间的差异以及每组术后偏差的变化。术后1天和6个月时,两组的升支高度和髁突倾斜度无统计学显著差异。观察到刚性固定组的放射密度较高,且两组的放射密度均随时间增加。半刚性固定组的手术时间明显短于另一组。半刚性固定和刚性固定在手术效果和结果方面无差异。在手术时间方面,半刚性固定优于刚性固定。