【摘要】：目的探討髁突囊內(nèi)骨折開(kāi)放手術(shù)中關(guān)節(jié)盤復(fù)位及固定方法的選擇及療效評(píng)判。方法選擇因髁突骨折接受手術(shù)治療,且隨訪期超過(guò)6個(gè)月的36例患者為研究對(duì)象,骨折類型以髁突矢狀骨折為主;術(shù)中采用長(zhǎng)螺釘內(nèi)固定,依據(jù)關(guān)節(jié)盤移位及損傷程度分別對(duì)關(guān)節(jié)盤采用縫合法(22側(cè))及錨固法(14側(cè))進(jìn)行復(fù)位。術(shù)后1、3、6個(gè)月及1年進(jìn)行隨訪,選擇手術(shù)前及手術(shù)后6個(gè)月為時(shí)間點(diǎn)詳細(xì)記錄Fricton顳下頜關(guān)節(jié)紊亂指數(shù)(CMI)相關(guān)的各項(xiàng)指標(biāo),從臨床和顳下頜關(guān)節(jié)(TMJ)功能兩方面評(píng)估術(shù)后恢復(fù)情況。結(jié)果兩組患者術(shù)后TMJ功能改善,CMI分別從治療前的0.213±0.162和0.273±0.154下降到0.059±0.072和0.064±0.068(P0.05)。兩組不同關(guān)節(jié)盤復(fù)位及固定方法之間比較,CMI、肌肉壓痛指數(shù)和TMJ功能障礙指數(shù)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 2種方法處理關(guān)節(jié)盤均可以有效地改善創(chuàng)傷導(dǎo)致的TMJ功能障礙,關(guān)節(jié)盤復(fù)位及固定方法的選擇以關(guān)節(jié)盤移位及損傷程度作為參考。
[Abstract]:Objective to investigate the choice of reduction and fixation of articular disc in open operation of intracapsular condylar fracture. Methods 36 patients with condylar fracture who received surgical treatment and were followed up for more than 6 months were selected as study subjects. The fracture type was mainly condylar sagittal fracture. Long screw fixation was used during the operation. According to the displacement of the disc and the degree of injury, the suture method (22 sides) and the anchor method (14 sides) were used to reposition the disc. Three months, six months and one year after operation were followed up. The indexes related to Fricton temporomandibular joint disorder index (CMI) were recorded in detail at the time points of 3 months, 6 months and 1 year after operation. To evaluate the postoperative recovery from clinical and temporomandibular joint (TMJ) function. Results the TMJ function of the two groups improved after operation, the CMI decreased from 0.213 鹵0.162 and 0.273 鹵0.154 to 0.059 鹵0.072 and 0.064 鹵0.068 respectively (P0.05). There was no significant difference in CMI, muscle tenderness index and TMJ dysfunction index between the two groups with different reduction and fixation methods (P0.05). Conclusion both methods can effectively improve the TMJ dysfunction caused by trauma. The choice of reduction and fixation of the disc is based on the displacement of the disc and the degree of injury.
【作者單位】： 南昌大學(xué)附屬口腔醫(yī)院口腔頜面外科江西省口腔生物醫(yī)學(xué)重點(diǎn)實(shí)驗(yàn)室;宜春市人民醫(yī)院口腔科;江西省中醫(yī)藥大學(xué)附屬醫(yī)院口腔頜面外科;
【基金】：江西省科技廳支撐計(jì)劃(20132BBG70095)~~
【分類號(hào)】：R782.6

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