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目的:比较髁突-翼外肌解剖复位与游离复位治疗髁状突骨折的疗效,促进髁突形态恢复。方法:收治的80例单侧髁状突骨折患者随机分为两组,每组40例,A组行髁突-翼外肌解剖复位术,B组行髁状突游离复位术,术后3个月、6个月观察髁突形态及下颌骨运动功能变化。结果:A组治愈率为90%,高于B组的70.00%(P<0.05);术后3个月A组髁状突吸收、张口受限、开口偏斜、咬合关系紊乱、关节弹响发生率分别为12.50%、15.00%、15.00%、7.50%、12.50%,均低于B组的32.50%、35.00%、37.50%、25.00%、35.00%(P<0.05);术后6个月A组张口受限、关节弹响发生率为5.00%、2.50%,均低于B组的20.00%、20.00%(P<0.05);两组术后并发症发生率比较差异无统计学意义(P<0.05)。结论:髁突-翼外肌解剖复位术保留髁状突骨折患者骨折断端血运,髁突形态及下颌骨运动能力恢复良好,疗效优于髁状突游离复位术。
Objective: To compare the effect of condylar-pterygoid anatomical reduction and free reduction on the treatment of condylar fractures and to promote the recovery of condyle morphology. Methods: Eighty patients with unilateral condylar fractures were randomly divided into two groups (n = 40 in each group). Group A received condylar-pterygoid anatomical reduction and group B received free condylar reset. After operation, Month and 6 months to observe condylar morphology and mandibular motor function changes. Results: The cure rate of group A was 90%, which was higher than that of group B (70.00%, P <0.05). At 3 months after operation, the condyles in group A had limited mouth opening, skewed opening, skewed opening, The incidence rates were 12.50%, 15.00%, 15.00%, 7.50% and 12.50% in group B respectively, which were all lower than 32.50%, 35.00%, 37.50%, 25.00% and 35.00% in group B (P <0.05) In group A, the mouth opening was limited and the incidence of joint snapping was 5.00% and 2.50%, both lower than 20.00% and 20.00% in group B (P <0.05). There was no significant difference in the incidence of postoperative complications P <0.05). CONCLUSION: The condylar-pterygoid anatomical reduction preserves the blood supply of fractures of the fractured condylar fractures. The condylar morphology and the ability of mandibular movement recover well, which is superior to the condylar dissociation.