Pittsburgh, Pa. From the Children's Hospital of Pittsburgh.
Plast Reconstr Surg. 2013 Jun;131(6):1348-1358. doi: 10.1097/PRS.0b013e31828bd503.
Optimal management of pediatric mandible fractures demands that the practitioner balance reduction and fixation with preservation of growth potential and function. The ideal synthesis of these goals has not yet been defined. The authors catalogue their experience with pediatric mandible fractures at a major pediatric teaching hospital with reference to demographics, injury type, treatment, and outcomes to inform future management of these injuries.
Demographics, management, and outcomes of pediatric mandible fractures presenting over 10 years at a pediatric trauma center were assessed. Cephalometric analysis was conducted. Relationships among demographics, fracture type, management, outcomes, and growth were explored.
Two hundred fifteen mandible fractures in 120 patients younger than 18 years were analyzed (average follow-up, 19.5 months). The condylar head and neck were fractured most frequently. Operative management was significantly more likely for children older than 12 years (p<0.05). Operative management and multiple fractures were significantly associated with a higher rate of adverse outcomes (p<0.05), but no adverse outcomes were considered to significantly affect mandibular function by patient or surgeon. No significant growth differences existed on cephalometric analysis between our cohort and age- and sex-matched controls (p>0.05).
This study reports the demographics, treatment, and early follow-up of a sizable cohort of pediatric mandible fractures. Management principles for these injuries are outlined. Although definitive recommendations must be withheld until longer follow-up is available, the data presented here show that the treatment protocols used at the authors' center have yielded largely uncompromised mandibular function and growth thus far.
儿科下颌骨骨折的最佳治疗方法要求医生在平衡复位和固定的同时，兼顾生长潜力和功能的保留。目前尚未明确这些目标的理想综合方案。作者通过对一家大型儿科教学医院的儿科下颌骨骨折患者的资料进行分类，参考其人口统计学特征、损伤类型、治疗方法和结果，为今后此类损伤的治疗提供信息。
评估了一家儿科创伤中心 10 多年来儿科下颌骨骨折患者的人口统计学特征、治疗方法和结果。进行了头影测量分析。探讨了人口统计学特征、骨折类型、治疗方法、结果和生长之间的关系。
共分析了 120 例年龄小于 18 岁的 215 例下颌骨骨折患者（平均随访 19.5 个月）。髁突颈部和头部是最常发生骨折的部位。12 岁以上的儿童更有可能接受手术治疗（p<0.05）。手术治疗和多发骨折与不良结局的发生率显著增加相关（p<0.05），但患者或外科医生均认为没有不良结局显著影响下颌骨功能。头影测量分析未显示本队列与年龄和性别匹配的对照组之间存在显著的生长差异（p>0.05）。
本研究报告了大量儿科下颌骨骨折患者的人口统计学特征、治疗方法和早期随访结果。概述了这些损伤的治疗原则。尽管在获得更长时间的随访结果之前，不能做出明确的建议，但目前提供的数据表明，作者所在中心使用的治疗方案迄今已使下颌骨功能和生长基本不受影响。
