하악 과두골절에 관한 임상적 연구: 효과적인 체외고정법
A clinical study on fractures of the mandibular condyles: effective extracorporeal fixation technique.
권광준, 정지훈, 김지혁, 박영욱,
소속 상세정보
권광준 ( Kwon Kwang-Joon ) - 강릉대학교 치과대학 구강악안면외과학교실
정지훈 ( Chung Ji-Hun ) - 강릉대학교 치과대학 구강악안면외과학교실
김지혁 ( Kim Ji-Hyuck ) - 강릉대학교 치과대학 구강악안면외과학교실
박영욱 ( Park Young-Wook ) - 강릉대학교 치과대학 구강악안면외과학교실
KMID : 0360120080300040359
Abstract
Purpose: Fractures of the mandibular condyle accounts for 15% to 30% of all the mandibular fractures and lots of complications are reported. Among these complications, condylar resorption is the most important one to be taken into account. The purpose of this study is evaluating condylar resorption pattern in relation to extracorporeal fixation technique.
Patients & Methods: Thirty four patients with 42 mandibular condylar fractures were retrospectively examined with an average follow-up of 18.5 months (6-66 months). Male/female ratio is 27 males (7 bilateral cases) and 7 females (1 bilateral case). Applicated surgical techniques were extracorporeal fixation via submandibular approach and extracorporeal fixation via intraoral approach. We compared radiographic views of post-operative periods with that of most long term follow up in 34 operated sites respectively.
Results:There were 2 generalized condylar resorption sites and 3 partial resorption sites with clinical implications. Others (29 joints) showed good healing or satisfactory adaptive state of temporomandibular joints clinically. Radiologically, signs of partial condylar resorption and/or osteoarthrosis were diagnosed in 11 patients. But, 8 out of the 11 patients didn’t show significant clinical symptoms, which means successful adaptive remodeling of the surgically located condyalr head.
Conclusion: From the above results, intentional ramal osteotomy, temporory detachment of the fractured condyle and extracorporeal fixation technique seems to be effective and useful in those cases of condylar fractures in which reduction of the dislocated condyle is very difficult or virtually impossible.
키워드
Fractures of mandibular condyle;Extracorporeal fixation;Condylar resorption pattern
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