摘要： 目的：探讨下颌骨髁突囊内骨折治疗的临床疗效。方法：24例28侧下颌骨髁突囊内骨折患者，分别进行保守治疗10例（后牙垫+前牙区颌间弹性牵引，或不处理骨折仅张口训练和观察）和手术治疗14例（髁突复位内固定+颌间牵引，下颌升支后缘离断髁突复位固定+颌间牵引），随访观察0.5～6年，对患者的自我感觉（疼痛）、开口度、咬合关系、下颌骨前伸和侧方运动、面神经功能及影像学检查等进行比较分析。结果：24例随访患者中，经过评估后保守治疗的10例各项观察指标恢复良好，手术组和非手术组各项观察指标对比，无统计学差异。结论：下颌骨髁突囊内骨折治疗前应进行综合评估，骨折移位不显著且无严重功能障碍的采用保守治疗效果较好，下颌升支后缘离断髁突复位固定的方法应慎用。

关键词: 下颌骨髁突囊内骨折；  , 保守治疗；  , 手术治疗

Abstract: Objective: To summarize the clinical experience and understanding of the management  on intracapsular condyle fracture. Methods: Retrospective review of 24 patients (28 sides). 10 cases were treated with non-surgical managements (cushion + intermaxillary traction / observation only ). 14 cases treated by surgical reduction (replacement and fixation mandibular condyle + intermaxillary traction / replantation of the condylar segment using the ramus osteotomy + intermaxillary traction) respectively. Assessment was based on clinical data of pre- and post-treatment panoramic radiographs, CT scan, three-dimensional CT reconstructions and clinical data (dental occlusion, maximum mouth opening, lateral excursion, protrusive movement, facial nerve function, pain), and follow-up period from 0.5~6 years. Results: Clinical data demonstrated no significant difference between surgical and non-surgical management patients. Conclusion: Comprehensive assessment of multiple  treatment  outcomes demonstrate that the non-surgical treatment is high on options of priority.  A technique such as replantation of the condylar segment using the ramus osteotomy can be used cautiously.

Key words:  intracapsular condyle fracture, non-surgical treatment, surgical treatment

中图分类号: 

• R782.4