下顎顆頭骨折 治療後의 豫後에 關한 臨床的硏究

A CLINICAL STUDY ON THE PROGNOSIS AFTER THE TREATMENT OF THE MANDIBULAR CONDYLE FRACTURES

This is a clinical study on the prognosis after the surgical or non-surgical management of condylar fractures of the mandible, by reviewing recent results of 43 patients followed-up for at least 6 months after the treatment in Ewha University Hospital from 1976 to 1985. The results were as follows; 1. Of 43 cases, 20.9% (9 cases) showed marked limitation of jaw excursion less than 30㎜ in interincisal opening; 18.6% (8 cases) followed by moderate temporomandibular joint dysfunction; 60.5% (26 cases) had no evidence of jaw dysfunction. 2. 47.0% of all disturbances in jaw excursion occurred in condylar head, 41.2% (7 cases) were in condylar neck, and only 1 case was in subcondylar portion. 3. Incidences of posttreatment disorders by the level of fractures were as 72.7% (8 of 11 cases) in condylar head, 26.9% (7 of 26 cases) in condylar neck, and only 1 case of 6 reductions in subcondylar fractures. 4. By the method of reduction, 58.8% of 17 complicated cases occurred after open reduction and 41.1% of them were after the closed reduction. And their incidences by number of treatments were as 46.0% of 23 open-reductions, while 35.0% of 20 closed-reductions. 5. Comparing the progonosis after the management by the level of fractures; ⅰ) Open reduction of condylar head fractures was followed by 77.7% (7 of 9 cases) of jaw dysfunctions, and closed reduction by only 1 of 2 cases. ⅱ) Open reduction of condylar neck fractures was followed by 30.0% (3 of 10 cases) of disorders, and closed reduction by 31.2% (5 of 16 cases) of dysfunctions. ⅲ) There was no complications after the open reduction of subcondylar fractures, and only 1 case of 2 closed-reductions. 6. By the period of intermaxillary fixation, relatively higher incidence of jaw-movement limitation was followed after 4-week-fixation(47.0%) and 6-week-fixation(42.8%) than 2- week-fixation (none of 6 cases) and 3-week-fixation (2 of 8 cases). But 3 of 5 cases of 1 -week-fixation, showed severe complications.