Paul Roger, Suvvada Bharathi, Polomarasetty Prasanna, Thumu Sai Kumar, Santosh P V
Department of Oral and Maxillofacial Surgery, Lenora Institute of Dental Sciences, Rajanagaram, Rajamahendravaram, Andhra Pradesh, India.
Department of Oral and Maxillofacial Surgery, Anil Neerukonda institute of Dental Sciences, Tagarapuvalasa, Vishakhapatnam, Andhra Pradesh, India.
Natl J Maxillofac Surg. 2022 Sep-Dec;13(3):405-410. doi: 10.4103/njms.njms_506_21. Epub 2022 Dec 10.
The aim of our study was to evaluate the effectiveness of open reduction and internal fixation of the base of condyle using a 3D 4-hole trapezoid condyle plate (4-HTCP).
A group of 25 subjects of an age range of 21-52 years (mean 32.7 ± 8.7 years) were treated of which, 7(28%) were female and 18 (72%), were male. All the patients were examined according to standard protocol. A retromandibular approach was used in all the patients.
The time taken for operating on the condyle alone was recorded it was between 30 minutes to one hour in 5 (20%) patients, between one-two hours in 19 (76%) patients and greater than two hours in 1 (4%) patient. Time taken from reduction of fracture to placement of the last screw was recorded. In 15 (60%) patients the time taken was less than ten minutes, in 10 (40%) patients the time taken ranged from 10-15 minutes. 6 (24%) patients needed additional exposure to facilitate the procedure. Postoperatively all the patients were followed up for a minimum of 9 months and a maximum of 30 months (mean 19.5 ± 5.87 months). The range of mandibular movements was satisfactory. The maximum incisal opening was in the range of 25-37 mm (mean- 31.4 ± 3.38 mm)on the first post-operative day. 31.4 ± 3.4 mm 6 weeks postoperatively, 43.8 ± 4.3 mm 3 months postoperatively, 46.7 ± 2.9 mm 6 months postoperatively and 49.7 ± 4.5 mm 9 months postoperatively. Taking into consideration the transient hypofunction of the facial nerve (8%) and TMJ disorder (8%) the aggregate complication rate in our study was 16%.
Our study concludes that 4HTCP is a reliable and rigid choice of osteosynthesis for the base of condyle fractures.
本研究的目的是评估使用三维四孔梯形髁钢板(4-HTCP)进行髁突基部切开复位内固定的有效性。
对一组年龄在21至52岁(平均32.7±8.7岁)的25名受试者进行治疗,其中7名(28%)为女性,18名(72%)为男性。所有患者均按照标准方案进行检查。所有患者均采用下颌后入路。
记录单纯对髁突进行手术的时间,5名(20%)患者的手术时间在30分钟至1小时之间,19名(76%)患者的手术时间在1至2小时之间,1名(4%)患者的手术时间超过2小时。记录从骨折复位到置入最后一枚螺钉的时间。15名(60%)患者的时间少于10分钟,10名(40%)患者的时间为10至15分钟。6名(24%)患者需要额外暴露以方便手术操作。术后所有患者至少随访9个月,最长随访30个月(平均19.5±5.87个月)。下颌运动范围令人满意。术后第一天最大切牙开口度在25至37毫米之间(平均31.4±3.38毫米)。术后6周为31.4±3.4毫米,术后3个月为43.8±4.3毫米,术后6个月为46.7±2.9毫米,术后9个月为49.7±4.5毫米。考虑到面神经短暂性功能减退(8%)和颞下颌关节紊乱(8%),本研究中的总并发症发生率为16%。
我们的研究得出结论,4HTCP是髁突骨折基部可靠且坚固的骨合成选择。