关键词: 髁突囊内骨折, 切开复位内固定, 下颌运动, 面神经损伤

Abstract: Objective To evaluate the clinical effect of modified tragus incision supraparotid approach on the treatment of intracapsular condylar fractures. Methods A retrospective study selected 13 cases (16 joints) of intracapsular condylar fractures who underwent surgery in the same treatment group in the Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University from January 2020 to December 2020. The effect of condyle reduction was evaluated with CBCT postoperatively. Occlusal relationship, mandibular function and facial nerve injury were evaluated at 3 and 6 months after operation. Results It was showed that effects of 14 sides were excellent; 1 side was good and 1 side was poor. Intermaxillary traction was performed in 3 of the 13 patients; the traction time was 3 to 7 days. All patients had a good occlusal relationship 3 months after operation; the opening was (37.46±6.91) mm; the forward movement was (6.34±1.21) mm; lateral movement to the healthy side was (5.45±1.54) mm, and to the affected side was (5.65±1.12) mm. Mandibular movement and chewing caused no discomfort or slight discomfort at 3 months after operation. There was no statistical difference of occlusal relationship and mandibular function between 3 months and 6 months postoperatively. There were 6 sides of facial nerve injury after surgery, 5 of which were difficulty in raising eyebrows and 1 of which was ptosis. Conclusion The modified tragus edge and supraparotid approach for treatment of intracapsular condylar fractures can effectively restore and fix the displaced fracture and the articular disc. Occlusal relationship, mandibular function and facial nerve injury recover well 3 months after the operation.

Key words: intracapsular condylar fracture, open reduction and internal fixation, mandibular movement, facial nerve injury