小切口切开复位外固定治疗髁状突骨折的临床观察

目的探讨小切口切开复位及颌间牵引外固定治疗髁状突骨折的疗效和临床应用价值。方法在2005年2月—2010年11月间,对18例有明显移位的髁状突骨折,采用经耳前、颌后或颌下小切口切开复位,并行牙弓夹板颌间牵引固定。术前、术后均行髁状突螺旋CT重建,了解髁状突骨折移位情况以及术后骨折复位固定效果。结果全部病例在术后3～4周去除颌间固定后,咬合关系恢复均良好,其中12例张口度基本正常,6例轻度张口受限;三个月后复查,仅1例轻度张口受限,其余张口度正常。影像学检查全部病例骨折对位愈合良好。结论小切口切开复位及颌间牵引固定术治疗髁状突骨折,具备复位好、创伤小、简单、安全、并发症少和患者容易接受等优点。

Clinical research of the treatment of condylar fracture by method of minithoracotomy and external fixation

Objective To explore the clinical ettect and value of open reduction through mmlthoracotomy, mtermaxlllary traction and external fixation in treating condylar fracture. Methods Totally 18 cases of significant displacement of the condylar fractures were chosen by adopting the method of open reduction through preauricula, jaw or lowerjaw, and arch bar splint fixation between February 2005 and November 2010. All patients＇ condylar fractures underwent CT （Computerized Tomography） and CT reconstruction, to understand the situation and the effect of postoperative fracture reduction and fixation before and after surgery. Result Three to four weeks after surgery, all patients＇ occlusion recovered well after the removal of inter-maxillary fixation, among whom 12 were cases were with normal mouth open, 6 cases with open-bite limitation. After three months,the subsequent consultation showed that only one case was with limitation of mouth opening, the rest all with normal occlusion. The imaging indicated that all patients fractures heal well. Conclusion Open reduction through minithoracotomy, intermaxillary traction and external for treating condylar fracture is a safe, effective, mini-invasive, perfectly -restored, method with few complication.