颌后切口入路髁突骨折的手术治疗

目的分析颌后切口入路髁突骨折的治疗方法及疗效。方法颌后切口入路,剖开腮腺下极,显露下颌升支及髁突。低位骨折,切口内直接对位固定;中位骨折,先切口内复位,预弯制钛板使之与骨面贴合,标志出螺钉钻孔位置后,将髁突夹持向下牵拉,垂直骨面钻孔,固定钛板,再复位固定升支部;高位骨折,下颌升支垂直斜形截骨,游离升支后缘骨块,并游离出髁突,体外将髁突与升支后缘骨块复位固定,将其回植于关节窝,后缘固定升支截骨线。结果35例均恢复正常咬合关系,张口度达3.5～4.0cm,面部对称。结论颌后切口手术治疗髁突骨折,显露充分,效果可靠。

Retromandbular Approach for Treatment of Condylar Fracture

Objective To analyze the methods and effects of retromandbular approach for condylar fracture. Methods Based on different situations of individual cases, different reposition and fixation methods were taken with a retromandbular approach to treat condylar fracture. Firstly subordinate parotid gland was cut and the ascending branch and condyle were exposed. Direct immobilization was used for the cases with lower fracture. In the neck fracture, reposition in incisions was used, and then the bending-plates were applied to bone surface and the drilling positions were marked followed by vertical drilling, and the plates were fixed with condylar stretching down. In condyle fracture in high position, mandibular ramus vertical oblique fracture was manifested and the ascending branch posterior border and condyle were freed, then the ascending branch and condyle were fixed in vitro and planted back in vivo. Results 35 patients recovered well, with a maximal mouth opening of 3.5 to 4.0cm. All patients got symmetric face figures. Conclusion Retromandbular approach may served as a satisfactory and reliable method for condylar fracture.