目的

探讨一种双侧髁突骨折的分类方法，根据分类将双侧髁突骨折进行分别治疗，比较治疗后的关节功能。

方法

63 例双侧髁突骨折按照髁突是否骨折以及升支高度是否发生降低分成3 类，每类中有3 个亚类，采用保守治疗和手术治疗，术后6 个月检查最大张口度、张口偏斜、单侧侧方运动、双侧侧方运动、前伸运动、关节弹响及杂音、有无前牙开等。

结果

无一例患者出现前牙开，有6 例最大开口度小于35 mm，都在Ⅰ型双侧髁突骨折，Ⅱ型双侧髁突骨折出现单侧侧方运动障碍、前伸障碍、开口偏斜、关节弹响及杂音各占10%，Ⅲ型双侧髁突骨折无明显关节功能障碍。

结论

双侧髁突骨折应当根据不同的情况进行分类治疗，有无髁突骨折对于关节功能的预后有很大影响，是否有升支高度降低对于采用哪种治疗方法起决定作用。

Objective

This retrospective study is aimed to explore a new classification of bilateral condylar fracture and to evaluate the therapeutic effects according to the classification.

Methods

According to the fracture of the condylar head and the changes of the ramus height， 63 cases of bilateral condylar fractures were classified into 3 types， and each one then divided into 3 subtypes. The patients received conservative treatment or operation， respectively. 6 months later， maximal mouth opening，mandibular deviation during opening， lateral movements， protrusive movements， clicking of the temporomandibular joints and the anterior open-bite were examined.

Results

After the treatment， the anterior open-bite was not observed in these cases. 6 patients classified in type Ⅰof the bilateral condylar fracture showed that the maximal mouth opening was less than 35 mm. 10% cases in typeⅡpresented disorders in lateral or protrusive movements， mandibular deviation and clicking of the joints，respectively. No obvious dysfunction of the temporomandibular joints was found in type Ⅲ.

Conclusions

Different treatment should be applied to patients with bilateral condylar fracture according to the fracture type. The fracture of the condylar head leads to poor prognosis of the joint function， while the changes of the ramus height may decide the treatment selection.