下颌髁突矢状骨折髓内髓外双重内固定术的临床应用

发布时间：2019-07-10 21:56

【摘要】：目的探讨髓内及髓外双重内固定在下颌髁突矢状骨折开放复位内固定中的应用价值。方法采用髓内髓外双重内固定术治疗18例24侧髁突矢状骨折,固定方法:单一螺钉或克氏针行髓内固定,配合一块钛板行髓外固定,伴发他处骨折者同期行精确复位固定。术后通过拍摄CT和全景X线片评价钛板固定情况、骨折段复位精准度及稳固性,通过临床检查评价咬合关系、开口度、开口型。结果术后X线全景片或CT检查显示,24侧髁突矢状骨折段均未发现术后旋转移位,对位良好;钛板和螺钉无扭曲、折断和松脱。术后咬合关系、开口度、开口型恢复良好。结论髓内髓外双重内固定具有抗骨折段旋转作用,髓内螺钉和髓外钛板在空间上互不干扰,是下颌骨髁突矢状骨折固定的良好方法。
[Abstract]:Objective to evaluate the value of intramedullary and extramedullary double internal fixation in open reduction and internal fixation of mandibular condylar sagittal fracture. Methods 18 cases (24 sides) of sagittal fracture of condyle were treated with intramedullary and extramedullary double internal fixation. Single screw or Kirschner wire was used for intramedullary fixation, external fixation with a titanium plate, and accurate reduction and fixation were performed at the same time. After operation, CT and panoramic X-ray films were taken to evaluate the fixation of titanium plate, the accuracy and stability of fracture reduction, and the occlusal relationship, opening degree and opening type were evaluated by clinical examination. Results X-ray panoramic film or CT showed that no rotation displacement and good alignment were found in 24 sides of sagittal fracture of condyle, while titanium plate and screw were not twisted, broken and loosened. The occlusal relationship, the degree of opening and the type of opening recovered well after operation. Conclusion Intramedullary and extramedullary double internal fixation has the effect of anti-fracture segment rotation, and intramedullary screw and extramedullary titanium plate do not interfere with each other in space, which is a good method for the fixation of mandibular condylar sagittal fracture.
【作者单位】：皖南医学院口腔医学院;安徽医科大学第三附属医院口腔颌面外科;安徽济民肿瘤医院口腔科;
【基金】：国家自然科学基金(815500037)~~
【分类号】：R782.4

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