Ghazal G, Jaquiéry C, Hammer B
Department of Reconstructive Surgery, Clinic for Maxillofacial Surgery, University Hospital, Basle, Switzerland.
Int J Oral Maxillofac Surg. 2004 Mar;33(2):141-5. doi: 10.1054/ijom.2003.0458.
Between January 1996 and January 2001 28 patients (nine females, nineteen males) with 35 fractures were treated by observation and soft diet only. Patients with isolated high condylar neck fractures were not included. The mean age at time of trauma was 35.6 years (5/80). Only patients with normal occlusion and radiologically undisplaced fractures were included. The follow-up time was 15 weeks on average (8/33). The patients did not undergo any active treatment. They just received the instruction to reduce mouth opening and to take a soft diet for 4 weeks. During the first 2 weeks after the trauma the patients were seen twice a week. Follow-up X-rays were performed after 4 and after 8 to 12 weeks. As a preemptive therapy antibiotics (amoxicillin plus clavulanic acid 2 x 1g/day) were given for 5 days. Spontaneous healing of all fractures was observed. In two patients a tooth had to be removed out of the fracture line. One patient complained about an occlusal problem after 1 week. In his case intermaxillary fixation was installed for 2 weeks. For forensic reasons the patients have to be fully informed about possible complications before indicating this type of management. Patient selection is crucial and requires a highly experienced surgeon. Patient inconvenience due to frequent consultations must be taken into consideration. This type of treatment can be recommended only in selected cases.
1996年1月至2001年1月期间，对28例患者（9名女性，19名男性）的35处骨折仅采用观察和软食治疗。不包括孤立的高位髁突颈部骨折患者。受伤时的平均年龄为35.6岁（5/80）。仅纳入咬合正常且放射学检查显示骨折无移位的患者。平均随访时间为15周（8/33）。患者未接受任何积极治疗。他们仅收到减少张口和食用软食4周的指示。创伤后的前2周，患者每周接受两次检查。在4周以及8至12周后进行随访X线检查。作为预防性治疗，给予抗生素（阿莫西林加克拉维酸，2×1g/天）5天。观察到所有骨折均自行愈合。两名患者因骨折线中有牙齿而不得不拔牙。一名患者在1周后抱怨存在咬合问题。该患者接受了2周的颌间固定。出于法医鉴定的原因，在采用这种治疗方式之前，必须向患者充分告知可能的并发症。患者选择至关重要，需要经验丰富的外科医生。必须考虑到频繁就诊给患者带来的不便。这种治疗方式仅在特定情况下推荐使用。
