【摘要】 目的比较合并同侧髁突骨折对陈旧性髁突脱位预后的影响。方法将陈旧性髁突脱位分为陈旧性髁突脱位并同侧髁突骨折(old dislocation and fracture of condyle process,ODFCP)20例和单纯陈旧性髁突脱位(old dislocation of condyle process,ODCP)12例两组,比较两组患者手术前后的张口度、张口型、咬关系、X线片表现及相关并发症的差异程度。结果术后两组患者的张口度和张口型比术前均有明显改善,但两组间差异无统计学意义。ODFCP组中18例咬关系恢复正常,2例术后出现患侧后牙早接触,前牙开;3例关节间隙不均匀;2例出现关节区疼痛和不适。ODCP组全部患者咬关系均恢复正常;1例关节间隙不均匀;1例关节弹响。结论陈旧性髁突脱位患者无论是否合并同侧髁突骨折,均不影响术后张口度的恢复和张口型的改善;除髁突骨折术后再移位和复位不当因素外,陈旧性髁突脱位合并髁突骨折并不影响咬关系的改善。更多还原

【Abstract】 Objective To compare the different operative results of old disloca tion condyle process with or without condylar fracture. Methods Thirty-two cases of old dislocation condyle process were divided into two groups: one was old disloc ation and fracture of condyle process (ODFCP) (20 cases); another was old disloc ation of condyle process (ODCP) without condylar fracture (12 cases). The posto p erative results were evaluated on the basis of maximal mouth opening, deviation, occluding relation and joint function, as well as radiographic assessment of TM J changes. Results After surgical treatment, the improvement of maximal mouth opening and the amendment of deviation were no statistic difference & between ODFCP and ODCP group. The occluding relation was turning into normal in 18 (90%) cases in ODFCP after treatment. While the syndromes included 2 case s open bite deformity at the site of anterior teeth, 3 cases asymmetric joint sp ace and 2 cases pain or discomfort in joint area in ODFCP. In the cases of ODCP , the occluding relation was turn into normal in all cases. While 1 case showed asymmetric joint space and 1 case of snap of TMJ. Conclusion B oth the maximal mouth opening and deviation in ODFCP and ODCP can be resumed aft er operation whether condylar process fracture occurs or not. The reason of mal occlusion in ODFCP and ODCP is due to the improper rigid fixing of fracture, or re-dislocation after surgical reposition.更多还原