网格状定位器在下颌骨髁突骨折手术切口选择中的应用

辛江波　陈卫伶　孙昊轩　袁渭　李菁菁　张曦　李志军　李东振

[摘要]目的：探讨应用网格状定位器在确定下颌骨髁突骨折手术切口选择中的应用。方法：将2014年-2017年在河北省眼科医院口腔颌面外科手术治疗的40例患者分为两组，应用网格状定位器确定下颌骨骨折皮肤切口位置。A组：20例，应用网格状定位器，手术治疗;B组：20例，传统经验手术切口治疗。比较手术时间，是否二次延长手术切口、并发症及预后等是否存在差异。结果：A组手术时间较B组减少约20min，无1例出现二次延长手术切口，并发症与预后两组无明显差异。 结论：应用网格状定位器可以在皮肤表面准确定位髁突骨折部位及骨折线走向，为手术切口选择提供明确依据，缩短了手术时间，避免了二次延长手术切口。

[关键词]下颌骨;髁突;骨折;定位;切口

[中图分类号]R782.4    [文献标志码]A    [文章编号]1008-6455（2020）08-0041-03

Application of Grid-like Positioner in Surgical Incision Selection for Fracture of Mandibular Condyle

XIN Jiang-bo1， CHEN Wei-ling2，SUN Hao-xuan1，YUAN Wei1，LI Jing-jing1，ZHANG Xi1，

LI Zhi-jun1，LI Dong-zhen1

（1.Department of Oral and Maxillofacial Surgery， Eye Infirmary， Xingtai 054001， Hebei，China;2.Dpartment of Head and Neck Surgery， First Hospital of Xingtai， Xingtai 054001，Hebei，China）

Abstract： Objective To explore the clinical application of mesh positioner in designed-incision for condylar fracture. Methods A total of 40 patients were treated by oral and maxillofacial surgery in hebei eye hospital from 2014 to 2017，and divide them into two groups，20 of them underwent surgery using a designed-incision locator （group A），Another 20 were operated on using traditional methods（group B）.This paper collected data on operation time and Whether to extend the incision， complications and outcomes of group A.The paper also conduct the contrast analysis with group B. Results  The operation time of the group A was about 20 minutes less than group B，No extended incision was observed.There were no significant differences between postoperative complications. Conclusion The mesh positionercan accurately locate the fracture site of condyle on the skin and determine the fracture line direction.Also，To use The mesh positioner，can shortens the operation time，And avoid extended surgical incision.

Key words： mandible; condylar; fracture; positioning;incision

髁突骨折發病率占下颌骨骨折的29%～52%[1]。髁突骨折常常引发患者面部畸形、开口受限、咬合错乱等症状[2-3]，目前髁突骨折的治疗多采用手术治疗，骨折手术入路目前主要有耳前入路、颌后入路、颌下入路及口内入路[4-6]，临床中需要根据髁突骨折位置的不同来选择手术入路。如何在皮肤表面准确定位骨折的具体位置及骨折线的走向，从而选择最佳的手术入路，是困扰临床医生的一个问题。自2014年以来，笔者科室应用网格状定位器定位髁突骨折的体表位置，取得了良好效果，为临床工作中髁突骨折手术路径的选择提供了依据，现报道如下。……