| Objective：To analyze the classification and corresponding operation methods ofmandibular condyle fracture. To conclude the indication and principle of theselection of operation methods by analyzing and assessing the treatment effect ofmandibular condyle fracture with different surgical methods retrospectively, toprovide an reference frame to the treatment of mandibular condyle fracture.Methods：We collect113cases (146sides) of mandibular condyle fracture in departmentof oral and maxillofacial surgery of the first affiliated hospital of zhengzhouuniversity from January2009to December2013. We evaluate the recovery ofmotor function after condyle free reset and condyle-lateral pterygoid anatomicalreduction from clinical and Imageological aspects. We choose the operation ofpretragal route or submandibular&postmandibular route according to the positionand character of the fracture line and complication fracture, and conduct condylefree reset or condyle-lateral pterygoid anatomical reduction according the damage ofcondyle, articular disc and lateral pterygoid muscle. The subsequent visit comeafter1month,3month,6month and1year respectively.Results：In113cases or146sides,90sides was conducted condyle-lateral pterygoidanatomical reduction, and56sides condyle free reset. According to the result ofpostsurgical shape assessment and CT examination after1year, we find8of90sides was conducted condyle-lateral pterygoid anatomical reduction and16of56sides condyle free reset undergo slight absorption. Postsurgical motor functionassessment: to observe the difference of condyle-lateral pterygoid anatomicalreduction and condyle free reset from opening degree,Opening style, clicking ofjoint and occlusal relationship etc. One month after surgery,26cases undergo slightrestriction of mouth opening, including11sides of condyle-lateral pterygoidanatomical reduction and15of condyle free reset. Three month after surgery, allof patients conducted with condyle-lateral pterygoid anatomical reduction restorenormal opening degree, but5of condyle free reset suffer slight opening restriction, and six month or one year fellow-up show3of them remain to be mouth openinglimited. Opening style: One month after surgery,23cases undergo openingdeflection including9of condyle-lateral pterygoid anatomical reduction and14ofcondyle free reset. Three month after reduction,8cases of patients suffer openingdeflection, including1of condyle-lateral pterygoid anatomical reduction and7ofcondyle free reset. After six month and one year follow-up7cases of condylefree reset who suffer opening deflection still unchanged. Occlusal relationship:3patients suffered Occlusal disorders including1case of condyle-lateral pterygoidanatomical reduction and2cases of condyle free reset. And all of them weremultiple fracture patients. After conducted with inter-arch elastic traction, theirocclusal relationship improved well to meet the demand to feed. Clicking of joint:3month after surgery,16cases of joint clicking show up,including5cases ofcondyle-lateral pterygoid anatomical reduction and11cases of condyle free reset.Six month and one year after surgery,7joints of condyle free reset remainclicking.Conclusion：1. Condyle-lateral pterygoid anatomical reduction restore the blood supply,which is conducive to healing of fracture.2、 Compared to condyle free reset,condyle-lateral pterygoid anatomical reduction could contribute to shape restore ofcondyle to provide better anatomical basis for recovery of temporal-mandibular jointfunction.3, Condyle-lateral pterygoid anatomical reduction work better thancondyle free reset in aspects of opening degree, opening style, clicking of joint,aswell as occlusal relationship. |
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