CAJ | 학술논문

目的：探讨拉力螺钉在髁状突囊内矢状骨折中的适用范围和应用技巧，并对疗效进行观察。方法选择重庆医科大学附属第一医院口腔颌面外科2006年1月至2012年12月收治的具有该手术指征的下颌骨髁突囊内矢状骨折患者21例（27侧），行切开复位内固定手术。其中24侧应用拉力螺钉复位内固定，3侧行髁状突骨碎片取出术，对患者术前术后的临床症状及影像学资料进行分析。结果术后平均随访17．4个月，21例患者均无面瘫、涎漏、螺钉松动发生，张口度及咬合关系恢复满意；3例患者因一侧行骨碎片取出术只做了单侧螺钉内固定术，术后出现不同程度的颞颌关节紊乱综合征；7侧术后关节头有影像学错位畸形及骨质轻度吸收，但功能基本正常。结论拉力螺钉可用于髁状突囊内矢状骨折，在恢复下颌升支高度及关节功能方面疗效确切。
목적：탐토랍력라정재과상돌낭내시상골절중적괄용범위화응용기교，병대료효진행관찰。방법선택중경의과대학부속제일의원구강합면외과2006년1월지2012년12월수치적구유해수술지정적하합골과돌낭내시상골절환자21례（27측），행절개복위내고정수술。기중24측응용랍력라정복위내고정，3측행과상돌골쇄편취출술，대환자술전술후적림상증상급영상학자료진행분석。결과술후평균수방17．4개월，21례환자균무면탄、연루、라정송동발생，장구도급교합관계회복만의；3례환자인일측행골쇄편취출술지주료단측라정내고정술，술후출현불동정도적섭합관절문란종합정；7측술후관절두유영상학착위기형급골질경도흡수，단공능기본정상。결론랍력라정가용우과상돌낭내시상골절，재회복하합승지고도급관절공능방면료효학절。
Objective To discuss the applicability and application skills of lag screw in condylar intracapsular sagittal fracture and also to observe its therapeutic effect .Methods We conducted surgical reduction and rigid internal fixation to 21 patients with 27 sides of condylar intracapsular sagittal fracture in department of oral and maxillofacial surgery of the first affiliated hospital of chongqing medical university .Fixation of 24 sides were carried out with lag screw and and the rest sides had condylar bone fragment removal surgeries .Imaging data and clinical symptoms of each side were analyzed before and after the treatment .Results After postoperative follow‐ups in average 17 .4 months ,there were no facial paralysis ,salivary fistula and loose screws in 21 patients .Al‐so ,the recoveries of mouth opening degree and occlusal relationship were satisfactory .There were different degrees of temporoman‐dibular joint disturbances syndrome for the 3 patients with just 1 side done with condylar bone fragment removal surgeries and screw internal fixation before .Seven sides of patients had malocclusion and slight bone absorption in image inspection after surgery . However ,the functions were basically normal .Conclusion Lag screw could be used in condylar intracapsular sagittal fracture and the effect in recovery of the height of ramus and the function of joints is exact .