Eskitascioglu Teoman, Ozyazgan Irfan, Coruh Atilla, Gunay Galip K, Yuksel Esabil
Department of Plastic and Reconstructive Surgery, School of Medicine, Erciyes University, Melikgazi, Kayseri, Turkey.
Ann Plast Surg. 2009 Nov;63(5):522-30. doi: 10.1097/SAP.0b013e318194fdab.
Maxillofacial fractures are encountered less commonly during childhood period due to anatomic, social, cultural, and environmental factors. Although the incidence of all maxillofacial fractures is 1% to 15% among pediatric and adolescent patients, this rate drops to less than 1% in children below 5 years age. Two hundred thirty-five cases (<or=16 age) with mandibular fracture were evaluated retrospectively. Patients records were examined in terms of age, gender, cause of fracture, fracture localization, number of fractures, fracture pattern, accompanying injuries, applied treatment methods, and complications. Mean age of cases was 9.2 years and 165 cases were male, 70 were female. Traffic accidents as the most common etiologic cause in all ages. Falls is the second most common cause which particularly affects children above age of 2 years. All cases had 333 fractures and the most common fracture localization was parasymphysis region (34%). The other most common fracture localizations were as follows: condyle (19%), corpus (13%), dentoalveolar region (12%), angulus (11%), symphysis region (9%), and ramus (2%). There was only a single fracture line in 145 cases, 40 cases had unilateral multiple and 50 cases had bilateral fracture lines. We applied symptomatic (conservative) treatment in 20 (8%) of our cases; fracture fixation with interdental wires or closed reduction methods were employed in 122 patients. Internal fixation with open reduction (OR) was performed on 51 (22%) patients. Both closed and OR techniques were carried out in 30 (13%) patients. Pediatric mandibular fractures, which are seen less frequently compared with those of adults, require a specific and different treatment. Although mostly less invasive methods are preferred, we believe that ORs should be considered when required.
由于解剖、社会、文化和环境因素，儿童期颌面部骨折相对少见。尽管在儿童和青少年患者中，所有颌面部骨折的发生率为1%至15%，但在5岁以下儿童中，这一比例降至1%以下。对235例（年龄≤16岁）下颌骨骨折患者进行了回顾性评估。检查患者记录的内容包括年龄、性别、骨折原因、骨折部位、骨折数量、骨折类型、伴随损伤、应用的治疗方法和并发症。病例的平均年龄为9.2岁，男性165例，女性70例。交通事故是各年龄段最常见的病因。跌倒为第二常见病因，尤其影响2岁以上儿童。所有病例共有333处骨折，最常见的骨折部位是下颌骨联合旁区域（34%）。其他最常见的骨折部位如下：髁突（19%）、体部（13%）、牙槽区（12%）、角部（11%）、联合区（9%）和升支（2%）。145例仅有一条骨折线，40例为单侧多发骨折，50例为双侧骨折线。我们对20例（8%）病例采用了对症（保守）治疗；122例患者采用牙间结扎丝固定或闭合复位方法进行骨折固定。51例（22%）患者采用切开复位内固定（OR）。30例（13%）患者同时采用了闭合和OR技术。与成人相比，小儿下颌骨骨折较少见，需要特定且不同的治疗方法。尽管大多首选侵入性较小的方法，但我们认为在必要时应考虑切开复位。
