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长期颞下颌关节脱位:综合综述与治疗方案建议

Long-Standing Temporomandibular Joint Dislocation: A Comprehensive Review and Proposal of a Treatment Algorithm.

作者信息

Yoshida Kazuya

机构信息

Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan.

出版信息

Medicina (Kaunas). 2025 Aug 22;61(9):1505. doi: 10.3390/medicina61091505.

Abstract

: Long-standing or protracted temporomandibular joint dislocation refers to a condition that persists for more than 1 month without reduction. To elucidate the clinical characteristics and treatment results of this condition, this comprehensive review analyzed the available data. : Studies were assessed using electronic medical databases and manual searches from their inception to 31 December 2024. : Overall, 229 cases (139 women and 81 men; mean age, 52.3 years) from 113 reports were assessed. The proportion of patients with bilateral and unilateral dislocations was 74.7% and 8.7%, respectively. The mean duration since dislocation was 11.9 months. Closed and open reductions were possible in 49 (21.4%) and 175 patients (76.4%), respectively. The mean dislocation duration was significantly ( = 0.001) shorter in patients who underwent closed reduction (4.9 months) than in those who underwent open reduction (14.8 months). : Clinically, it is crucial to diagnose and treat this condition early to prevent it from becoming chronic. However, for cases of long-standing dislocations due to other more serious diseases, conservative treatments such as manual reduction and continuous elastic traction should be attempted first. If reduction fails, surgical treatment should be performed as an alternative.

摘要

长期或迁延性颞下颌关节脱位是指脱位持续1个月以上未复位的情况。为阐明该病症的临床特征和治疗效果,本综述分析了现有数据。研究通过电子医学数据库和自起始至2024年12月31日的手工检索进行评估。总体而言,对113篇报告中的229例病例(139例女性和81例男性;平均年龄52.3岁)进行了评估。双侧和单侧脱位患者的比例分别为74.7%和8.7%。脱位后的平均时长为11.9个月。分别有49例(21.4%)和175例患者(76.4%)可行闭合复位和开放复位。接受闭合复位的患者(4.9个月)的平均脱位时长显著短于接受开放复位的患者(14.8个月)(P = 0.001)。临床上,早期诊断和治疗该病症以防止其转为慢性至关重要。然而,对于由其他更严重疾病导致的长期脱位病例,应首先尝试手法复位和持续弹性牵引等保守治疗。若复位失败,则应选择手术治疗。

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