成人下颌骨髁突骨折的手术治疗

对成人髁突骨折采用手术与非手术治疗,学术界一直存在着不同程度的分歧。随着各种小型接骨板、坚强内固定技术的成熟应用,许多学者主张对成人双侧髁突颈部以下脱位性骨折,双侧髁突矢状外脱位性骨折,单侧髁突颈部以下脱位性、移位性骨折行积极外科手术治疗。对髁突骨折患者行外科手术、坚强内固定治疗,可以保证骨折固定具备坚固性和稳定性,并尽早行使功能。本文对髁突骨折外科手术治疗的固定方式、手术入路(耳前入路、下颌下入路、颌后入路、除皱手术入路和近年来报道增多的内窥镜辅助下口内入路)的选择进行了阐述。

Surgical Operation and Rigid Internal Fixation of Mandibular Condyle Fractures in Adults

There is still controversy about the management of mandibular condyle fractures.However,with the successful application of titanium plates and the techniques of rigid internal fixation,consensus on surgical intervention in treating bilateral subcondyle fracture,bilateral condyle sagittal fracture with dislocation and unilateral subcondylar fracture with dislocation or displacement in adults,have been reached.The purpose of surgical treatment of condyle fracture is to restore ramus height and acquired enough stability to perform its function.This article concluded the experiences of surgical fixation and surgical approaches,such as preauricular approach,submandibular approach,retromandibular approach, rhytidectomy approach and endoscopic assisted intraoral approach,that are used in the management of fractures of the mandibular condyle.