摘要
目的探讨从髁突外侧旋入优选长度钛钉固定治疗下颌骨髁突矢状骨折(SFMC)的临床方法及疗效。方法依据上下颌骨CT三维重建结果,对髁突矢状骨折内侧骨折片超过1/3髁突长的22例(28侧),测量髁突内外侧径长度,根据测量结果,选择16mm长钛钉作为最佳长度,行髁突矢状骨折解剖复位后,从髁突外侧用3枚16mm长钛钉行平行固定,术后1、3、6个月进行临床和影像学复查。结果 22例(28侧)病例的髁突外形良好,钛钉无松动、脱落,下颌运动和功能满意,开口度≥3.5 cm;术后3例要求取出固定钛钉未能全部取出。结论髁突外侧入路长钛钉固定治疗髁突矢状骨折钉长16mm为优选长度,疗效确切,操作简单,省时,创伤小,术后3个月可以评价其效果。术后不必取出固定长钛钉,但是对于其与髁突增龄性变化的关系还有待进一步观察。
Objective To investigate the clinical procedures and efficacy of internal fixation using titanium screws with a preferential length through lateral approach in treating sagittal fracture of the mandibular condyle（SFMC）.Methods According to the three-dimensional CT reconstruction results of superior and inferior maxillary bones,medial and lateral radial lengths of condyles of 22 SFMC patients（28 sides） with medial bone fragments longer than 1/3 of the condylar length were measured.The measurement results indicated that 16mm was established as the preferential length of long titanium screws.After anatomical reduction of the sagittal condylar fracture,the condyle was fixed using three 16mm long titanium screws through the lateral approach 1,3 and 6 months after the surgery,clinical and radiological reexaminations were performed.Results Good results were obtained in all of the 22 patients（28 sides）,manifested as favorable condylar morphology,absence of screw loosening or detachment,satisfactory mandibular movement and function as well as mouth openings ≥3.5cm;the titanium screws were not all taken out in three patients who requested withdrawal.Conclusion The preferential length of titanium screws through lateral approach for fixation in treating SFMC is 16mm.Internal fixation using 16mm long screws proves to be an effective,simple,timesaving and minimally invasive method for SFMC.It is not necessary to take out long titanium screws after the surgery,but the relationship between rigid internal fixation and aging-related changes of condyles still requires further observation.
出处
《现代口腔医学杂志》
CAS
CSCD
2011年第3期174-178,共5页
Journal of Modern Stomatology
基金
宁波市重点学科建设资金资助(2008口腔医学)
关键词
髁突矢状骨折
坚强内固定
解剖复位
长钛钉
Sagittal condylar fracture Rigid internal fixation Anatomical reduction Long titanium screws
