[上颌骨脱位骨折后髁突路径的变化]。

H Feifel, D Riediger
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引用次数: 0

摘要

尽管在面中骨折后使用微型钢板进行刚性内固定,但先前活动的碎片在背侧方向脱位是可能的。因此,下颌骨将被迫在咬合上进入背侧位置。因此,髁突路径的改变,如限制或偏离正常,将是可能的。对6例持续性面中骨折伴上颌骨脱位或活动的患者进行了随访。在刚性内固定和取出微型钢板后,尽可能早地记录髁突路径。我们使用电子计算机辅助配准系统(ECRS),它允许三维配准而不受咬合干扰。颞下颌关节的运动模式没有受损,反驳了上颌骨的背侧移位。然而,即使没有进行上颌间固定,在一些病例中,术后头几周的活动范围也明显减少。我们认为,这是由于关节周围浸润和关节囊在不同方向的弹性变化所致。
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[Changes in the condyle path following fractures with dislocation of the maxilla].

In spite of rigid internal fixation with miniplates after midfacial fractures, dislocation of the previously mobilized fragment in the dorsal direction is conceivable. Thus, the mandible would be forced into a dorsal position over the occlusion. As a result, changes of the condyle paths, such as limitations or deviations from the normal, would be possible. Six patients, who had sustained midfacial fractures with mobilization or dislocation of the maxilla, were followed up. The condyle paths were recorded at the earliest time possible after rigid internal fixation and after removal of the miniplates. We used the electronic computer-assisted registration system (ECRS), which allows three-dimensional registration without occlusal interferences. The patterns of the TMJ movements were not impaired, arguing against the dorsal transposition of the maxilla. The extent of the movements during the first postoperative weeks, however, was significantly reduced in some cases, even if intermaxillary fixation was not carried out. In our opinion, this is due to the periarticular infiltration and a varying elasticity of the articular capsule in different directions.

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