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新型内镜辅助长钢板入路用于下颌髁突骨折重建的初步研究

Novel Endoscopic-Assisted Long Plate Approach for Mandibular Condylar Fracture Reconstruction-A Preliminary Study.

作者信息

Huang Chao-Hsin, Lee Chia-Chen, Wu Yi-Chia, Lee Hsiao-Chen, Kuo Yur-Ren, Lee Su-Shin

机构信息

Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Kaohsiung J Med Sci. 2025 Aug;41(8):e70033. doi: 10.1002/kjm2.70033. Epub 2025 May 19.

Abstract

Mandibular condylar fractures can lead to facial asymmetry, malocclusion, and temporomandibular joint instability. To minimize the risk of these issues, endoscopic-assisted reduction techniques were developed. Nevertheless, the confined working space inherent in endoscopic procedures poses challenges, especially in cases with unstable fracture sites, movable plates, and screws. To solve this dilemma, we developed a novel surgical technique using long plate for condylar fracture fixation. "Long Plate Technique" involves a long plate being stabilized via the submandibular incision site, with screws inserted through the trocar to affix the titanium plate onto the superior condylar segment from the tragus incision site. A total of 98 patients were included in this study. The overall average operation time was 365 min. Specifically, the average operation time for the group treated with closed reduction and intermaxillary fixation was 250 min, for Group B cases treated with short plate open reduction and intermaxillary fixation was 429 min, and for Group C treated with long plate open reduction and intermaxillary fixation was 413 min. The utilization of the Long Plate Technique provides a secure and efficient operation technique that can lessen the stress on surgeons during the operation.

摘要

下颌髁突骨折可导致面部不对称、咬合不正和颞下颌关节不稳定。为了将这些问题的风险降至最低,人们开发了内镜辅助复位技术。然而,内镜手术固有的工作空间有限带来了挑战,尤其是在骨折部位不稳定、钢板和螺钉可移动的情况下。为了解决这一难题,我们开发了一种使用长钢板固定髁突骨折的新型手术技术。“长钢板技术”是指通过下颌下切口部位稳定一块长钢板,通过套管针插入螺钉,将钛板从耳前切口部位固定到髁突上段。本研究共纳入98例患者。总体平均手术时间为365分钟。具体而言,闭合复位颌间固定治疗组的平均手术时间为250分钟,短钢板切开复位颌间固定治疗的B组病例平均手术时间为429分钟,长钢板切开复位颌间固定治疗的C组平均手术时间为413分钟。长钢板技术的应用提供了一种安全有效的手术技术,可减轻手术过程中外科医生的压力。

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