拉力螺钉在髁状突囊内矢状骨折中的临床应用及疗效观察

目的：探讨拉力螺钉在髁状突囊内矢状骨折中的适用范围和应用技巧，并对疗效进行观察。方法选择重庆医科大学附属第一医院口腔颌面外科2006年1月至2012年12月收治的具有该手术指征的下颌骨髁突囊内矢状骨折患者21例（27侧），行切开复位内固定手术。其中24侧应用拉力螺钉复位内固定，3侧行髁状突骨碎片取出术，对患者术前术后的临床症状及影像学资料进行分析。结果术后平均随访17．4个月，21例患者均无面瘫、涎漏、螺钉松动发生，张口度及咬合关系恢复满意；3例患者因一侧行骨碎片取出术只做了单侧螺钉内固定术，术后出现不同程度的颞颌关节紊乱综合征；7侧术后关节头有影像学错位畸形及骨质轻度吸收，但功能基本正常。结论拉力螺钉可用于髁状突囊内矢状骨折，在恢复下颌升支高度及关节功能方面疗效确切。

Clinical application and efficacy of lag screw in condylar intracapsular sagittal fracture

Objective To discuss the applicability and application skills of lag screw in condylar intracapsular sagittal fracture and also to observe its therapeutic effect .Methods We conducted surgical reduction and rigid internal fixation to 21 patients with 27 sides of condylar intracapsular sagittal fracture in department of oral and maxillofacial surgery of the first affiliated hospital of chongqing medical university .Fixation of 24 sides were carried out with lag screw and and the rest sides had condylar bone fragment removal surgeries .Imaging data and clinical symptoms of each side were analyzed before and after the treatment .Results After postoperative follow‐ups in average 17 .4 months ,there were no facial paralysis ,salivary fistula and loose screws in 21 patients .Al‐so ,the recoveries of mouth opening degree and occlusal relationship were satisfactory .There were different degrees of temporoman‐dibular joint disturbances syndrome for the 3 patients with just 1 side done with condylar bone fragment removal surgeries and screw internal fixation before .Seven sides of patients had malocclusion and slight bone absorption in image inspection after surgery . However ,the functions were basically normal .Conclusion Lag screw could be used in condylar intracapsular sagittal fracture and the effect in recovery of the height of ramus and the function of joints is exact .