Clinical Application And Effect Observation Of Long Screw In The Type A Of Diacapitular Condylar Fracture Of Mandible

Objective: To investigate the clinical effect of long screw in the type A of diacapitular condylar fracture of mandible.Methods: Totally 19 patients with type A of unilateral diacapitular condylar fracture were computed tomography from February 2016 to July 2017 in the First Affiliated Hospital of Dalian Medical University.Patients were divided into Two groups:surgical treatment group 10 cases,conservative treatment group 9 cases,surgery group were treated with long screws.The patients were followed up at 1,3,6,and 12 months after treatment,with review of the occlusal relationship,the degree of opening and so on.With CT examination records the patient condylar absorption and condylar reset,compared the clinical therapeutic effect of two groups' patients.Result:1.Comparing the general data of patients before treatment,such as age,opening degree,occlusion disorder,gender,the difference was not statistically significant.There was no facial paralysis in the two groups before treatment symptom.2.(1)Occlusal relationship:In the 12 th month after the treatment,all patients in the surgical treatment group had a basic restoration of the pre-injury state.In the conservative treatment group,there were still 3 patients with occlusion disorder.There were significant statistical differences between the two groups in the occlusal relationship after treatment 1,3,6 and 12 months(P <0.05).(2)Vertical opening degree: In the surgical treatment group,all patients after reseted and fixed the condylars in the intraoperative procedure,and review the passive opening degree was up to 35 mm.In the first and third months after the treatment,the differences in the two groups were statistically significant,P=0.000,P=0.001(P < 0.05);and the difference was observably.In the 6th and 12 th month,there were statistically significant differences between the two groups,P=0.042,P=0.048(P < 0.05).(3)The temporomandibular joint with shot,ache and murmur: The two groups showed statistically significant difference(P<0.05)during the third month after treatment.Surgical treatment can improve the pain and murmur of the joint in the early.No statistically significant difference(P>0.05)was found between the two groups after the follow-up of 6 and 12 th months after treatment.(4)Condyle absorption: In the third month after treatment,there was no statistically significant difference between the two groups(P>0.05);In the 6th and 12 th month after treatment,the two groups had statistically significant differences(P<0.05).(5)Condylar restoration and reconstruction: healing record whether condylar anatomy reset or dislocation healing reconstruction;1,3,6,12 th months after treatment there is statistical significance difference comparing the two groups(P < 0.05).(6)Improvement of Postoperative symptom: In the experimental group,2 patients suffered from facial paralysis after operation.Patients in the surgical treatment group were given symptomatic treatment such as physical therapy.12 th months after surgery,the review of facial paralysis in the two patients were completely disappeared.Conclusion:1.Compared with conservative treatment,the long screws apply to the type A of diacapitular condylar fracture of mandible surgical treatment,can improve occlusal relationship and the temporomandibular joint with shot,ache and murmur in the early.In order to reduce condyle absorption,improve occlusal relation and condyle reposition,long screw operation was better than conservative treatment.2.The long screw has the advantages of wide source and low cost while ensuring clinical efficacy,and it is worth popularizing in clinical application.Due to the small number of cases and short clinical follow-up time,the long-term effects of long screw clinical application need to be further observed.