Franke A, Matschke J B, Sembdner P, Seidler A, McLeod N M H, Leonhardt H
Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany.
Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany.
Int J Oral Maxillofac Surg. 2025 Jul;54(7):598-606. doi: 10.1016/j.ijom.2025.01.018. Epub 2025 Feb 14.
The treatment of mandibular fractures affecting the condylar head (CHF) can be either closed or open. In the case of an open approach, the headless bone screw (HBS) is an option. This study was performed to investigate the efficacy of osteosynthesis with HBS using three-dimensional radiographic imaging and clinical evaluation over long-term follow-up. This was a single-centre retrospective study. Clinical parameters and three-dimensional radiographic scans were collected during follow-up, DICOM datasets were segmented, and model analysis was conducted. Forty-five patients who received a HBS and met the eligibility criteria were included. There were significant improvements in all clinical parameters (mouth opening, protrusion, laterotrusion; all P < 0.05) except for the laterotrusion of the unaffected side (P = 0.071). Mean volume and surface area changes (from postoperative (mean 1.9 days) to final follow-up (mean 1675 days)) were 127.2 mm and -22.4 mm, respectively, and were not statistically significant (P = 0.18 and P = 0.51). There were radiographic signs of condylar remodelling. Nine HBS in nine patients required removal due to the screw penetrating the articular surface of the healing condylar head. This single-centre retrospective study found good functional outcomes using HBS for CHF, with a screw removal rate of 20%.
影响髁突头部的下颌骨骨折（CHF）的治疗方法可以是闭合性的，也可以是开放性的。在采用开放性手术的情况下，无头接骨螺钉（HBS）是一种选择。本研究旨在通过三维影像学检查和长期随访的临床评估，探讨使用HBS进行骨接合术的疗效。这是一项单中心回顾性研究。随访期间收集临床参数和三维影像学扫描数据，对DICOM数据集进行分割，并进行模型分析。纳入了45例接受HBS且符合入选标准的患者。除未受影响侧的侧方移位（P = 0.071）外，所有临床参数（开口度、前突、侧方移位；所有P < 0.05）均有显著改善。平均体积和表面积变化（从术后（平均1.9天）到最终随访（平均1675天））分别为127.2 mm和-22.4 mm，差异无统计学意义（P = 0.18和P = 0.51）。有髁突重塑的影像学征象。9例患者中的9枚HBS因螺钉穿透愈合髁突头部的关节面而需要取出。这项单中心回顾性研究发现，使用HBS治疗CHF可获得良好的功能结果，螺钉取出率为20%。
