髁突骨折切开复位与闭合复位治疗后CT扫描及临床参数的比较评价

Anu Jose, Satyajit Dandagi, Girish V. Chour, Sushmit P. Bora, Minu Parvathi Dharan
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引用次数: 0

摘要

背景:下颌骨折是仅次于鼻骨的第二常见的面骨骨折。25%到40%的下颌骨骨折涉及髁突。在文献中,对于下颌骨髁突骨折的治疗没有一致的“金标准”,对于髁突骨折是应该进行闭合复位还是开放复位一直存在争议。材料与方法:选取20例行切开复位和闭合复位治疗的患者。术后至少3个月评估临床最大切间开口、侧伸和突出运动、开口疼痛、咬合错误、开口下巴偏差、面神经麻痹、血肿、种植体感染和咬合力。此外,术后进行CT检查以评估碎片的解剖位置。结果:在临床参数评价上,两组具有可比性。而切开复位组无一例患者在开口时出现下颌骨偏离中线的情况。切开复位组也能获得更好的解剖定位。结论:本研究结果提示切开复位是治疗下颌髁突骨折较好选择。
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Comparative evaluation of post treatment CT scan and clinical parameters in open reduction and closed reduction treatment of condylar fractures
Background: Mandibular fracture is the second most common fracture of facial bone, next to nasal bone. Twenty-five to forty percent of mandibular fractures involve the condyle. In the literature, there exists no consensus “gold standard” treatment for mandibular condylar fractures, and there is a continuing debate on whether condylar fractures should undergo closed or open reduction. Materials and Method: Twenty patients who had undergone open reduction and closed reduction treatment were included in the study. Clinically maximal interincisal opening, laterotrusive and protrusive movements, pain on mouth opening, malocclusion, chin deviation on mouth opening, facial nerve palsy, hematoma, infected implant, and bite force were evaluated after a minimum of 3 months postoperatively. Also, a postoperative CT is done to evaluate the anatomical position of fragment. Results: On evaluation of clinical parameters, both groups had comparable results. However, none of the patients in open reduction group had deviation of mandible from midline on mouth opening. Also, better anatomical repositioning is obtained in open reduction group. Conclusion: The results of this study suggest that the open reduction method is a better alternative to closed reduction in treatment of mandibular condylar fractures.
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