関節突起骨折に対する治療法の適応に関する検討 顎機能による評価

Abstract

Controversy surrounds the indications for surgical or non-surgical treatment of fractures of the mandibular condyle. In this study, the recovery of mandibular function in 238 patients with condylar fractures of the mandible treated surgically or non-surgically at our department between 1981 and 1996 was analyzed on the basis of impairment score to evaluate the efficacy of treatment. The results are summarized as follows:1. There was no statistically significant difference between the surgical and non-surgical treatment groups with regard to fracture type or location, but a slightly better outcome was obtained after surgical treatment in patients with fractures of the condylar neck and base with deviation, displacement, and dislocation. Severe dysfunction remained in patients treated nonsurgically for condylar neck and base fractures with dislocation.2. The recovery of mandibular function in patients with fractures of the condyle with dislocation was significantly poorer than that in patients without dislocation.3. Better mandibular function was obtained in the unilateral fracture group than in the bilateral fracture group.4. No functional problems occurred in patients 9 years of age or youngers.5. In patients 10 to 29 years of age, there was no difference in mandibular function according to fracture type or location between the surgical and non-surgical patients.6. The recovery of mandibular function in patients older than 30 years with fractures of the condylar neck and base with deviation, displacement, and dislocation was better in the surgical group than in the non-surgical group.Our results suggest that surgical treatment is indicated for patients older than 30 years who have fractures of the condylar neck and base wiht deviation, displacement, and dislocation.