下顎頸部骨折時の小骨片が下顎切痕部に癒着して拘縮症を生じた小児の一例 A case of temporomandibular joint pseudoankylosis of a fractured condyle that fused to the mandibular notch in childhood
A case of unilateral temporomandibular joint (TMJ) pseudoankylosis of a fractured condyle that fused to the mandibular notch is presented. A 6-year-old girl who had a traumatic accident at the age of 1 and a half years developed pseudoankylosis of the right TMJ. After the accident, she was transported to an orthopedic clinic for an X-ray examination. No bone fractures were evident. She had difficulty in opening her mouth after the injury, but no doctors were consulted until she was 3 and a half years old. She then underwent another X-ray examination by an oral and maxillofacial surgeon. The surgeon claimed that she suffered a fracture during the accident and recommended a mouth opening exercise. He later referred the patient to us because the exercise was not effective. The interincisal distance on mouth opening was 15mm at presentation.<BR>A panoramic X-ray film and CT examinations showed that a fractured condyle had fused to the mandibular notch struck against a zygomatic arch, resulting in hypomobility of the mandible. The patient underwent open surgery under general anesthesia. The operation included complete resection of the fused condylar segment and a rigid fixation of it to the stump of the condyle with titanium screws. Two years 10 months after surgery, the interincisal distance on mouth opening was 37mm, and no disturbance of jaw development or asymmetry of the face was observed.
日本口腔外科学会雑誌 53(3), 155-159, 2007-03-20
Japanese Society of Oral and Maxillofacial Surgeons