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单侧髁突骨折后的咀嚼肌功能:一项前瞻性定量肌电图研究。

Masticatory muscle function after unilateral condylar fractures: a prospective and quantitative electromyographic study.

作者信息

Hjorth T, Melsen B, Møller E

机构信息

Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, University of Aarhus, Denmark.

出版信息

Eur J Oral Sci. 1997 Aug;105(4):298-304. doi: 10.1111/j.1600-0722.1997.tb00244.x.

Abstract

Electromyographic (EMG) recording of masticatory muscle activity was performed in 9 adult men with unilateral condylar fracture immediately after conservative treatment of the condylar fracture (T0) and 4 (T1) and 8 (T2) months after the trauma. From T0 to T2, maximal voluntary contraction of the anterior and posterior temporal muscles and of the masseter muscle opposite the fracture side (contralateral) increased significantly. Activity in the anterior temporal muscles also rose significantly during natural chewing, whereas the masseter muscles remained at the same level, but activity consistently tended to be strongest contralaterally to the condylar fracture. In addition, there was a tendency from T1 to T2 for natural chewing to take place predominantly on the contralateral side. The most obvious overall changes during the follow-up were shorter and stronger contractions in all muscles during chewing, on the side of the impaired joint. The increase of activity in the anterior temporal muscles during maximal bite and natural chewing, and the occurrence of stronger and shorter contractions during ipsilateral chewing, were interpreted as signs of improved function due to healing and relief of pain from the impaired joint. On the other hand, there was a specific rise of maximal activity only in the contralateral masseter, and during natural chewing, activity was constantly stronger in the same muscle in combination with the tendency of increasing predominance of contralateral strokes. These traits specifically related to the masseter muscles were considered an indication of a permanent functional distortion due to reflex suppression on the fracture side as an after-effect of the injury.

摘要

对9名单侧髁突骨折的成年男性在髁突骨折保守治疗后立即(T0)、伤后4个月(T1)和8个月(T2)进行咀嚼肌活动的肌电图(EMG)记录。从T0到T2,颞前肌、颞后肌以及骨折侧对侧(对侧)咬肌的最大自主收缩显著增加。在自然咀嚼时,颞前肌的活动也显著增强,而咬肌活动保持在同一水平,但活动始终倾向于在与髁突骨折对侧最强。此外,从T1到T2有自然咀嚼主要发生在对侧的趋势。随访期间最明显的总体变化是在受损关节一侧,所有肌肉在咀嚼时收缩更短且更强。颞前肌在最大咬合力和自然咀嚼时活动增加,以及同侧咀嚼时出现更强且更短的收缩,被解释为由于愈合和受损关节疼痛缓解导致功能改善的迹象。另一方面,仅对侧咬肌的最大活动有特定增加,并且在自然咀嚼时,同一肌肉的活动持续更强,同时对侧咀嚼动作的优势增加趋势明显。这些与咬肌特定相关的特征被认为是由于损伤后遗症导致骨折侧反射性抑制而造成永久性功能扭曲的迹象。

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