摘要目的 探讨成人下颌骨髁突矢状骨折的临床特点、治疗方法、治疗效果等.方法 对2010年1月至2016年6月收治于北京大学口腔医学院·口腔医院口腔颌面外科病房成人髁突矢状骨折151例住院病例的临床资料进行回顾性分析,包括年龄、性别、致伤原因、骨折线位置、移位程度、治疗方法、治疗效果等.结果 患者年龄为16~81岁,中位年龄38.5岁,男女比例为2.97∶1,发病年龄段为20~29岁[35.1%(53/151)],常见的致伤原因为摔伤[53.6%(81/151)].患者常见骨折类型分别为A型[60.5%(130/215)]及移位型[80.9%(174/215)].不同骨折类型之间手术率及固定方式的差异有统计学意义(P<0.05).78.7%(59/75)的手术治疗患者术后咬合良好、无关节症状、无下颌运动受限.保守治疗患者咬合可,6侧髁突矢状骨折5侧出现畸形愈合.结论 在合适的手术适应证下,髁突矢状骨折的手术治疗效果较保守治疗明显.

abstractsObjective A retrospective research was made to summarize the clinical characteristics, treatment methods, results of the adult cases with sagittal fracture of mandibular condyle (SFMC). Methods One hundred and fifty-one cases of hospitalized patients were enrolled. The age, sex, etiology, level of fracture, degree of displacement, associated facial fractures, treatment methods and results were retrospectively analyzed. Results The patient′s age ranged from 16 to 81 years old, with a median age of 38.5 years. The male to female ratio was 2.97∶1. The most involved age group was 20?29 years old [35.1% (53/151)]. Falls [53.6% (81/151)] were the most common cause. According to the classification of He (2009) and Duan (2011), the most common type of SFMC was type A [60.5% (130/215)] and the displacement type [80.9% (174/215)]. Eighty-six point zero percent (185/215) of SFMC were treated by surgery. The surgical rates of type A, B and M fractures were 91.5% (119/130), 79.6% (43/54) and 88.5% (23/26), with significant differences between the groups (P＜0.05). The surgical rates of the displacement and dislocation type were 89.7% and 100%, with significant differences. The differences between the fixations of type A, type B and type M fractures were statistically significant. The follow?up results showed that, 78.7% (59/75) of patients treated with surgery had normal occlusion, no joint symptoms and no limited mandibular movement. Patients treated with conservative therapy had good occlusion and an average maximum mouth opening of 36.25 mm with malunion occurred in 5/6 of the condyles. Conclusions Under appropriate surgical indications, surgical treatment of SFMCs could achieve significantly better outcomes than conservative treatment.