关节结节骨折的治疗

目的介绍关节结节骨折的不同治疗方法。方法关节结节骨折35例,术前根据双眶水平位CT将骨折线分为2型:矢状型和斜线型。术中用冠状切口显露关节结节复位后,根据暴露情况及骨折线类型,用单枚或双枚微型钛钉或微型钛板固定。所有患者术前、术后均拍摄双眶水平及冠状位CT、头面部三维CT并进行比较。结果24例采用微型钛板固定,8例采用单枚微型钛钉固定,3例采用双枚微型钛钉固定。术后所有患者面形基本对称,术前术后CT片对比骨折复位良好。结论关节结节骨折的固定可以恢复颧骨前后方向及侧方形态,根据暴露情况及骨折线类型应采取不同的固定方法。

The Treatment of Temporomandibular Joint Tubercle Fracture

Objective To introduce different kinds of treatment for temporomandibular joint tubercle fracture. Methods According to fracture line in orbital axial CT, 35 cases of temporomandibular joint tubercle fracture were preoperatively devided into two types: sagital type and oblique type. Coronal incision was applied and temporomandibular joint tubercle fracture was reduced and fixed using one or two microscrews or microplates during operation. Orbital axial CT and coronal CT, three-dimension CT scan were performed in all cases preoperatively and postoperatively. Preoperative CT was compared with postoperative CT. Results Microplate fixation was applied for 24 cases, one microscrew fixation for 8 cases, two microscrews fixation for 3 cases. All the temporomandibular joint tubercle fractures were reduced correctly. Facial configuration of all the patients were restored and symmetrical. Conclusion The normal anterior and lateral of zygomatic process was resered after temporomandibular joint tubercle fracture reducing. Different methods of fixation were applied in accordance with exposure of fracture and types of fracture line.