Delay Alexandra, Olivetto Matthieu, Bettega Georges, Dehaene Déborah, Lartizien Rodolphe
Service de Chirurgie Maxillo-Faciale, Centre Hospitalier d'Annecy Genevois, Annecy, France.
Service de Chirurgie Maxillo-Faciale, Centre Hospitalier d'Annecy Genevois, Annecy, France.
J Stomatol Oral Maxillofac Surg. 2024 Oct 31;126(5):102133. doi: 10.1016/j.jormas.2024.102133.
Condylar process fractures remain a matter of ongoing controversy in maxillofacial surgery because of variety of opinions and proposed treatment modalities offered in the literature. The trend is toward open reduction and internal fixation (ORIF) whenever there is displacement or dislocation combined with unstable occlusal conditions. The fundamental treatment goals are anatomical fixation and early return to function. However, ORIF of a fractured condyle carries significant risks, including facial nerve damage, and presents challenges in reducing and stabilizing the fractured segment in an area of limited access. We present here an innovative technique for ORIF of condylar head fractures. It consists in fracture reduction and stabilization with two Kirschner wires followed by osteosynthesis with two cannulated headless compression screws using the AUTOFIX 2.0® system (Stryker, Kalamazoo, USA). This new technique, combined with intraoperative CT scan, ensures satisfactory reduction and stabilization of the dislocated joint segment, thereby restoring the condyle to its physiologically normal position.
由于文献中存在各种观点和提出的治疗方式，髁突骨折在颌面外科领域仍然是一个持续存在争议的问题。当出现移位或脱位并伴有不稳定咬合情况时，趋势是采用切开复位内固定术（ORIF）。基本的治疗目标是解剖复位固定并尽早恢复功能。然而，髁突骨折的切开复位内固定术存在重大风险，包括面神经损伤，并且在有限的手术区域内对骨折段进行复位和固定也面临挑战。我们在此介绍一种用于髁突头部骨折切开复位内固定术的创新技术。该技术包括先用两根克氏针进行骨折复位和固定，然后使用AUTOFIX 2.0®系统（美国密歇根州卡拉马祖市史赛克公司）用两根空心无头加压螺钉进行骨合成。这项新技术与术中CT扫描相结合，确保脱位的关节段得到满意的复位和固定，从而使髁突恢复到其生理正常位置。
