摘要
本文报告成人髁状突骨折移位手术治疗的３９例（４１侧）术式是依Ｘ线诊断，临床表现、骨折部位、移位程度及致伤时间所定，即传统直接复位１１例，不游离髁突的升支切开解剖复位１６例（１８侧），游离髁突的升支切开复位固定关节重建术８例，游离髁突和升支骨段倒置关节术２例，乙状切迹下升支倒Ｌ型前徙术２例，下颌升支矢状劈开１例，无１例髁状突摘除。本文讨论了手术指征、术式选择和手术程序。对手术术式进行改进，对１６例髁突中、低位伴前内移位病人施行不游离髁突的升支切开解剖复位术取得满意效果。这一术式因不剥离髁状突而保证翼外肌对其血供，更符合颞下颌关节正常生理解剖结构，是目前成人移位髁突骨折进行解剖复位比较有效方法。
?9 cases(41sides) were treated with different open reduction.The selection of fracture,degree of displacement,clinical manifestation,X-ray examination and time of trauma,that included 11 cases of traditional open reduction,16 cases(18 sides) of anatomical reduction in subcondylar oblique ramus osteotomy without detaching condyle,8 cases of arthroplasty in oblique ramus osteotomy with detaching condyle,2 cases of arthroplasty in oblique ramus osteotomy with detaching condyle upside-down,2 cases of rebersed L-shaped osteotomy through sigmoid nolch and 1 case of sagittal split ramus osteotomy.no condylectomy was carried out.The result comfirmed that anatomical reduction of oblique ramus osteotomy without detaching condyle is an effective method for the treatment of anterior-medial displaced condylar fractures in dults,because the condylar fragment was not detached,the vascular supply from the lateral pterygoid muscle and the normal TMJ structure were preserved.The author discussed emphatically on the indication of the surgical treatment,the choice of the operative method and the operative procedures.
出处
《口腔颌面外科杂志》
CAS
1997年第4期239-240,238,共3页
Journal of Oral and Maxillofacial Surgery
